双平面开放楔形胫骨高位截骨术的术后康复研究  

Postoperative Rehabilitation of Biplane Open Wedge High Tibial Osteotomy

作　　者：钟珊[1] 柳剑[2] 黄野[2] Zhong Shan;Liu Jian;Huang Ye(Rehabilitation Department of Beijing Jishuitan Hospital,Beijing 100035,China;Department of Orthopedics, Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院康复医学科,北京100035 [2]北京积水潭医院矫形骨科,北京100035

出　　处：《实用骨科杂志》2021年第10期881-885,共5页Journal of Practical Orthopaedics

摘　　要：目的总结分析双平面开放楔形胫骨高位截骨术(open wedge high tibia osteotomy,OWHTO)术后系统康复疗效,为制订标准化康复方案提供参考。方法应用双平面OWHTO治疗膝关节内侧骨关节炎患者27例(39膝),其中男12例,女15例;单侧15例,双侧12例。按年龄分为青年组(18~29岁)、中青年组(30~49岁)、中老年组(50~75岁),根据Takeuchi合页骨折分型制订相应康复方案,随访3~6个月。应用疼痛视觉模拟评分(visual analogue score,VAS)对所有患者术后第2天下地和术后3个月的疼痛进行评估、对患者术前及术后最远行走距离进行比较、记录患者完全脱离拐杖时间。结果所有患者术后初次下地与术后3个月VAS疼痛评分比较差异有统计学意义(P<0.05);18~29岁和50~75岁两组患者术前和术后3个月最远行走距离差异有统计学意义(P<0.05),30~49岁组差异无统计学意义;18~29岁组患者平均2个月完全脱离拐杖,30~49岁和50~75岁组患者平均2.5个月完全脱拐。结论双平面OWHTO是一种有效、安全的治疗膝关节内侧间室骨关节炎的手术方式,可以很好地改善疼痛、恢复活动能力,在制订标准化康复方案时应综合考虑患者的年龄、活动需求、术中情况等多方面因素。Objective To summarize and analyze the effect of systematic rehabilitation after biplane open wedge high tibial osteotomy(Biplane OWHTO),so as to provide reference for the development of standardized rehabilitation program.Methods 27 patients(39 knees)with medial knee osteoarthritis were treated with biplane open wedge HTO.They were divided into young group(18~29 years old),middle-aged group(30~49 years old)and middle-old aged group(50~75 years old)according to age.According to the classification of Takeuchi hinge fracture,the corresponding rehabilitation program was formulated,and followed up for 3~6 months.VAS(visual analogue score)was used to evaluate the pain of all patients on the second day after operation and three months after operation,to compare the longest walking distance of patients before and after operation,and to record the time of patients completely leaving crutches.Results There was significant difference in VAS pain score between the first time and 3 months after operation in all patients(P<0.05).There was significant difference in the farthest walking distance before and 3 months after operation between 18~29 years old group and 50~75 years group(P<0.05),but there was no difference in 30~49 years old group.The mean time of complete walkwithout crutch was 2 months in the group of 18~29 years old,and 2.5 months in the group of 30~49 years old and 50~75 years old.Conclusion Biplane OWHTO is an effective and safe surgical method for the treatment of medial compartment osteoarthritis of the knee,which can improve the pain and restore the ability of activity.The age,activity needs,intraoperative conditionsand other factors of the patients should be taken into account when formulating the standardized rehabilitation program.

关 键 词：双平面 胫骨 截骨术 术后康复 

分 类 号：R687.31[医药卫生—骨科学]