膝关节镜结合外侧闭合式胫骨高位截骨治疗膝骨性关节病内侧间隙疼痛的临床效果  

Clinical effect of knee arthroscopy combined with lateral closed high tibial osteotomy in the treatment of medial space pain in genicoosseous arthropathies

作　　者：韩廷成[1] 祁兆建[1] 陈大志[1] 顾荣胜[1] 孟庆国[1] 陆华[1] 范广峰 董松林[1] 田敏[1] HAN Ting-cheng;QI Zhao-jian;CHEN Da-zhi(Department of Bone injury,Yancheng Hospital of Traditional Chinese Medicine,Affiliated to Nanjing University of Traditional Chinese Medicine,Yancheng 224001,China)

机构地区：[1]南京中医药大学附属盐城市中医院骨伤科,江苏盐城224001

出　　处：《吉林医学》2021年第11期2582-2586,共5页Jilin Medical Journal

基　　金：江苏省盐城市科技局项目,批文文号:盐卫科教【2018】21号[项目编号:YK2018048]。

摘　　要：目的:探讨关节镜下对关节腔内有限的清理结合外侧闭合式胫骨高位截骨治疗膝内侧间隙疼痛的临床效果观察。方法:本研究回顾性收集并分析骨伤科于2016年1月~2018年1月期间住院的膝骨性关节病内侧间隙疼痛的共48例患者作为研究对象,采用关节镜加外侧闭合胫骨高位截骨治疗和单纯行关节镜下关节腔内有限的清理治疗;将其分为治疗组和对照组各24例,治疗组:关节镜加外侧闭合胫骨高位截骨治疗;对照组:单纯行关节镜下关节腔内有限的清理治疗。参照HSS膝关节评分即纽约特种外科医院(hospital for special surgery knee score,HSS)、Lysholm评分、股骨胫骨角Femor-Tibial Angle(FTA)及胫骨近端外侧解剖角(Anatomic Angle of proximal lateral tibia aLPTA)等指标来评估疗效。经过术后6个月、12个月、18个月、24个月的随访。结果:两组术前、术后6个月、12个月、18个月、24个月HSS评分,Lysholm评分末次随访治疗组的优良率明显高于对照组,差异有统计学意义(P<0.05)。治疗组术后的股骨胫骨角(FTA)和胫骨近端外侧解剖角(aLPTA)高于术前,差异有统计学意义(P<0.05),对照组术后的股骨胫骨角(FTA)和胫骨近端外侧解剖角(aLPTA)高于术前,差异有统计学意义(P<0.05),但治疗组术后6个月、12个月、18个月、24个月的随访,总疗效明显高于对照组,差异有统计学意义(P<0.05)。结论:关节镜结合外侧闭合胫骨高位截骨治疗膝内侧间隙疼痛明显减轻,较好地改善下肢力线,总体疗效尚满意。Objective To investigate the clinical effect of arthroscopic limited clearance of the articular cavity combined with lateral closed high tibial osteotomy in the treatment of medial knee space pain.Method this study collected and retrospectively analyzed in department of orthopedics from January 2016 to January 2018 in hospital during the period of knee osseous arthritis pain inside clearance as the research object,a total of 48 patients with arthroscopy and lateral line closed tibia bone cutting treatment and high pure clear articular cavity limited treatment under arthroscopy;The patients were divided into the treatment group and the control group,with 24 patients in each group.The treatment group was treated by arthroscopy and closed lateral tibial plateau osteotomy.Control group:arthroscopic treatment was performed only with limited clearance of the articular cavity.Refer to HSS knee joint The scores were presented by the New York Hospital for Special Surgery Knee Score(HSS),Lysholm score,femor-Tibial Angle of the tibia(FTA),and Anatomic Angle of proximal lateral tibia aLPTA to evaluate the curative effects.The patients were followed up 6,12,18 and 24 months after operation.Results HSS scores at 6,12,18 and 24 months before and after operation were obtained in the 2 groups,and the excellent and good rate of Lysholm score in the last follow-up treatment group was significantly higher than that in the control group,with statistically significant differences(P<0.05).Treatment group of postoperative femoral tibial Angle(FTA)and proximal tibia lateral anatomic Angle(aLPTA)was higher than before,the difference was statistically significant(P<0.05),the control of postoperative femoral tibial Angle(FTA)and proximal tibia lateral anatomic Angle(aLPTA)is higher than before,the difference was statistically significant(P<0.05),but the treatment group after 6,12,18,24 months of follow-up,the total curative effect was significantly higher than the control group(P<0.05).Conclusion Arthroscopy combined with closed upper tibia

关 键 词：膝关节镜 外侧闭合式胫骨高位截骨 膝骨性关节病 膝内侧间隙痛 

分 类 号：R687.4[医药卫生—骨科学]