腓骨近端截骨联合膝关节镜下关节清理术治疗膝关节骨性关节炎的疗效分析  

Proximal tibia and fibula osteotomy combined with arthroscopic joint debridement in treatment of knee osteoarthritis

作　　者：霍丽丽[1] 颉朝阳[1] 崔小雷[1] Huo Lili;Xie Chaoyang;Cui Xiaolei(Department of Orthopedic Joints of Hengshui No. 4 People's hospital, Hengshui, 053000, China)

机构地区：[1]衡水市第四人民医院关节骨科,053000

出　　处：《中华老年骨科与康复电子杂志》2017年第5期306-309,共4页Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)

摘　　要：目的探讨腓骨近端截骨联合膝关节镜下关节清理术治疗膝关节骨性关节炎的疗效。方法回顾性分析2014年4月至2015年8月行腓骨近端截骨联合膝关节镜下关节清理术治疗膝关节骨性关节炎患者32例(35膝),其中男性7例(22%),女性25例(78%)。年龄43~71岁,平均(53±3)岁;左膝13例(41%),右膝16例(50%),双膝3例(9%),膝关节骨性关节炎分级Ⅰ级0例(0%),Ⅱ级5例(16%),Ⅲ级20例(62%),Ⅳ级7例(22%),分别在术前、术后一个月对患膝进行美国特种外科医院膝关节评分(HSS),疼痛视觉模拟评分(VAS)及膝关节内侧间室高度变化的比较。结果所有患者均获得满意随访,随访时间3~15个月,平均(9±2)个月。HSS评分术前(52.7±1.3)分改善至术后末次随访(80.5±0.9)分,差异有统计学意义(t=18.930,P<0.01),其中优26膝、良7膝、可2膝,术后优良率达94.3%。VAS评分术前的(6.59±0.21)分降至术后一个月的(2.34±0.16)分,差异有统计学意义(t=20.655,P<0.01),内侧间室高度由术前的(2.90±0.12)mm提高至术后的(5.97±0.21)mm,差异具有统计学意义(t=12.921,P<0.01)。所有患者中4例出现腓浅神经损伤,无深静脉血栓形成、感染等并发症发生。结论腓骨近端截骨联合膝关节镜下关节清理术治疗膝关节骨性关节炎可减轻患者疼痛,改善膝关节功能及影像学表现,术后并发症少。Objective To explore the effect of proximal fibula osteotomy combined with arthroscopic joint debridement in the treatment of knee osseousarthritis.Methods A retrospective analysis was done in32knee osteoarthritis(35knees)from April2014to August2015treated with proximal fibula osteotomy combined with knee arthroscopic debridement.There were7males(22%)and25females(78%)with an average of53±3years(43-71years),left in13cases(41%)and right in16patients(50%),bilateral in3patients(9%).There was no Grade I(0%)knee osteoarthritis,5cases were Grade II(16%),20cases were Grade III(62%)and7Grade IV(22%).Before surgery and at one month postoperatively,respectively recorded and compared the knee using United States Hospital of special surgery knee score(HSS),visual analog scale(VAS)and changes in the medial compartment of knee joint.Results All patients were satisfactorily followed up for3to15months,average9±2months.Preoperative HSS score were43±3points,lower than one month postoperative(87.7±3.3points),difference was statistically significant(t=18.930,P<0.01).Overall26knees were excellent,7were Good and2knees were fair,The excellent and good rate was94.3%.Preoperative VAS score were6.8±0.5points,higher than one month postoperative(2.5±0.5points),difference was statistically significant(t=20.655,P<0.01).Height of the medial compartment was improved from2.90+0.12mm preoperatively to5.97+0.21mm postoperatively,difference was statistically significant(t=12.921,P<0.05).Superficial nerve injury occurred in4patients.No deep venous thrombosis,infection and other complications occurred.Conclusion Proximal osteotomy combined with knee arthroscopic debridement for knee osteoarthritis can relieve pain,improving the function of knee joint and imaging performance,reducing the postoperative complications.

关 键 词：膝关节 骨关节炎 截骨术 膝关节镜 关节清理 

分 类 号：R687.4[医药卫生—骨科学]