关节镜联合胫骨高位截骨术治疗膝关节内侧间室骨性关节炎  

Arthroscopy combined with high tibial osteotomy for knee osteoarthritis of medial compartment

作　　者：马亮 蔡余力[1] 刘金豹 陈文明 张文强[2] 刘帅 于永杰[3] 任金亭 李刚[1] MA Liang;CAI Yu-li;LIU Jin-bao(Department of Orthopedics,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China)

机构地区：[1]山东中医药大学附属医院骨科,山东济南250014 [2]山东省千佛山医院骨科 [3]潍坊市益都中心医院骨科

出　　处：《腹腔镜外科杂志》2020年第9期708-711,共4页Journal of Laparoscopic Surgery

基　　金：山东省医药卫生科技发展计划项目(2018WS075);山东省科学技术厅重点研发计划项目(2019GSF108112)。

摘　　要：目的:探讨关节镜联合胫骨高位截骨术治疗膝关节内侧间室骨关节炎的近期临床疗效。方法:回顾分析2018年8月至2019年7月采用关节镜联合胫骨高位截骨术治疗37例内侧间室膝骨关节炎患者的临床资料。术前及术后采用下肢力线比率、胫骨近端内侧角评估下肢力线情况。采用视觉模拟评分与美国特种外科医院评分评估膝关节功能恢复情况。结果:37例患者均获得随访,下肢力线比率与胫骨近端内侧角均得到有效矫正,差异有统计学意义。视觉模拟评分与美国特种外科医院评分较术前改善,差异有统计学意义。5例患者术中出现合页点骨折,予以拉力螺钉固定。结论:关节镜联合胫骨高位截骨术可有效矫正膝关节内翻畸形,调整下肢力线,改善膝关节疼痛及功能障碍。Objective:To investigate early clinical effect of arthroscopy combined with high tibial osteotomy for patients with knee osteoarthritis of medial compartment.Methods:The clinical data of 37 patients with medial compartment knee osteoarthritis treated by arthroscopy combined with high tibial osteotomy from Aug.2018 to Jul.2019 were retrospectively analyzed.Weight bearing line and medial proximal tibial angle were analyzed to assess lower limb alignment before and after surgery.Visual analogue scale and hospital for special surgery score were used to evaluate knee joint functional recovery.Results:All patients were followed up.Weight bearing line and medial proximal tibial angle were significantly improved after surgery.Hospital for special surgery score and visual analogue score were significantly improved compared with those before operation.Five cases of hinge fracture were fixed by lag screw during surgery.Conclusions:Arthroscopy combined with high tibial osteotomy could adjust varus defection of knee and lower limb alignment effectively,relieve knee pain and dysfunction.

关 键 词：骨关节炎 膝 胫骨高位截骨术 关节镜检查 

分 类 号：R684.3[医药卫生—骨科学]