关节镜清理联合胫骨高位外侧闭合截骨Giebel钢板内固定治疗内翻型膝关节骨性关节炎的疗效  

Efficacy of arthroscopic debridement combined with high lateral tibial osteotomy and Giebel plate internal fixation in the treatment of varus knee osteoarthritis

作　　者：宋德臣[1] 邢斌[1] 苏向伟 李玉军[2] 李瑞[1] Song Dechen;Xing Bin;Su Xiangwei;Li Yujun;Li Rui(Department of Orthopaedics,Beijing Delcony Orthopaedics Hospital,Beijing 100143,China;Department of Orthopaedics,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京德尔康尼骨科医院骨四科,100143 [2]北京积水潭医院矫形骨科,100035

出　　处：《中国医师杂志》2020年第7期1035-1039,共5页Journal of Chinese Physician

摘　　要：目的 探讨关节镜清理联合胫骨高位外侧闭合截骨Giebel钢板内固定治疗内翻型膝关节骨性关节炎的临床效果.方法 选取2016年1月至2018年6月北京德尔康尼骨科医院应用关节镜清理联合胫骨高位外侧闭合截骨Giebel钢板内固定治疗的78例(96膝)内翻型膝关节骨性关节炎患者,对患者进行随访,并对术前、术后股胫角(FTA)及特种外科医院膝关节功能评分(HSS)进行比较.结果 70例(86膝)患者获完整随访,随访12~ 28(22.4±0.2)个月,胫骨高位截骨处在术后8 ~14周均达到骨性愈合,随访患者疼痛症状消失或明显缓解,复查下肢应力位X线片检查显示力线维持在术后水平.膝股胫角术前为(187.6±0.4)°,术后为(172.5±0.3)°,差异有统计学意义(P<0.05).HSS膝关节评分标准:优70膝,良10膝,中4膝,差2膝,优良率93.0%.HSS评分由术前的(69.0±3.6)分提高至末次随访的(87.2±8.1)分,差异有统计学意义(P<0.05).结论 关节镜清理联合胫骨高位外侧闭合截骨Giebel钢板内固定治疗内翻型膝关节骨性关节炎是一种良好的方法,值得临床进一步推广应用.Objective To investigate the clinical effect of arthroscopic debridement combined with high lateral tibial osteotomy and Giebel plate internal fixation in the treatment of varus knee osteoarthritis.Methods From January 2016 to June 2018,78 patients(96 knees)with varus knee osteoarthritis in Beijing Delcony Orthopedic hospital were treated by arthroscopic debridement combined with closed lateral tibial osteotomy and Giebel plate internal fixation.The femoral tibial angle(FTA)and hospital for special surgery knee score(HSS)score of knee joint were compared before and after operation.Results 70 patients(86 knees)were followed up for 12 to 28 months,with an average of 22.4 months.Bone healing was achieved at the osteotomy site 8 to 14 weeks after operation.Pain symptoms were relieved or disappeared significantly.The force line of X-ray examination was maintained at the postoperative level.The average knee femoral tibial angle was 187.6°preoperatively and 172.5°postoperatively,which showed significant statistical difference(P<0.05).HSS knee score criteria:excellent:70 knees;good:10 knees;medium:4 knees;poor:2 knees.The excellent and good rate was 93.0%.The HSS score increased from(69.0±3.6)before operation to(87.2±8.1)after operation,with significant difference(P<0.05).Conclusions Arthroscopic debridement combined with high lateral tibial osteotomy and Giebel plate internal fixation is a very good method for the treatment of varus knee osteoarthritis,which is worthy of further clinical application.

关 键 词：关节镜检查 骨关节炎 膝 膝内翻 截骨术 内固定器 

分 类 号：R687.4[医药卫生—骨科学]