单纯腓骨小段截除术与腓骨小段截除术+内固定治疗膝骨关节炎临床疗效比较  

Comparison of the outcomes of the treatment for knee osteoarthritis between single fibular osteotomy and fibular osteotomy with fixation

作　　者：李存祥 王立卫 李德思 LI Cunxiang;WANG Liwei;LI Desi(Department of Orthopedic Surgery,the People's Hospital of Ningjin County,Ningjin 055550,China;Medical Department,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,China)

机构地区：[1]河北省宁晋县医院骨科,河北宁晋055550 [2]河北医科大学第三医院医务处,河北石家庄050051

出　　处：《医学研究与教育》2020年第6期29-34,共6页Medical Research and Education

摘　　要：目的比较单纯腓骨小段截除术与腓骨小段截除术+内固定术治疗膝骨关节炎的临床疗效。方法回顾性分析自2012年6月至2018年12月宁晋县医院单纯腓骨小段截除术(单纯截骨组)与腓骨小段截除术+内固定术(内固定组)治疗内翻型膝骨关节炎患者各50例。术前测量股胫角、股胫关节间隙角、下肢力线至膝关节中线距离、K&L分级,进行JOA评分,所有患者分别于术后2个月、6个月、12个月随访、测量、评分及进行效果评价。结果100例患者获得满意随访,术前2组患者的JOA评分差异无统计学意义(P>0.05)。内固定组66.00%患膝近期(2个月)即可达术后无痛,90.00%患膝术后6个月疼痛基本缓解,12个月基本无痛;单纯截骨组仅34.00%患膝近期术后无痛,80.00%患膝术后6个月疼痛基本缓解,86.00%患者12个月基本无痛。2组患者早期JOA评分明显提高,且与术前相比差异均有统计学意义(P<0.05)。结论腓骨小段截除术+内固定术和单纯腓骨小段截除术治疗膝骨关节炎均能取得良好疗效,但腓骨小段截除术+内固定术与单纯腓内小段截除术相比,治疗有一定优势。Objective To evaluate the clinical outcomes of fibular osteotomy with and without fixation in the treatment of knee osteoarthritis patients.Methods We retrospectively evaluated the clinical outcomes and radiographic parameters from June 2012 to December 2018,in 100 knee osteoarthritis patients who underwent single fibular osteotomy or fibular osteotomy with fixation,50 patients in each group.The changes in the femoro-tibial angle(FTA),femorotibial angle(JS angle)on X-ray,the Japanese Orthopedic Association Knee Score(JOA score)were compared after the operation for 2 months,6 months,12 months.Results All patients were conducted followed-up study.No significant differences in JOA were observed between the groups before the operation(P>0.05).66.00%of the patients who underwent fibular osteotomy with fixation got pain relief in short term(after 2 months),90.00%patients got pain relief after 6 months,nearly all patients were observed pain relief after 12 months.While in the other group,there was 34.00%patients got pain relief in short term(after 2 months),80.00%patients got pain relief after 6 months,86.00%patients got pain relief after 12 months.FTA,JS angle were significant decreased in both groups,most patients exhibited improved walking postoperatively.Conclusion Satisfactory outcomes can be achieved with both operations in patients with knee osteoarthritis,however,fibular osteotomy with fixation indicates faster recovery and better early stability than simple fibular osteotomy.

关 键 词：腓骨 截骨术 内固定 膝关节 骨关节炎 

分 类 号：R68[医药卫生—骨科学]