针刀镜联合腓骨近端截骨术治疗膝骨关节炎20例  

20 Cases Clinical Study for Arthroscopic Needle Knife Combined with Proximal Fibula Osteotomy for Knee Osteoarthritis

作　　者：齐万里[1] 于东旭 高宏伟[1] 邓伟[1] 韩继成[1] QI Wanli;YU Dongxu;GAO Hongwei;DENG Wei;HAN Jicheng(Hospital Affiliated to Changchun University of Traditional Chinese Medicine,Changchun 130021,China;Changchun University of Traditional Chinese Medicine,Changchun 130117,China)

机构地区：[1]长春中医药大学附属医院,长春130021 [2]长春中医药大学

出　　处：《中国中医骨伤科杂志》2021年第11期58-60,共3页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：吉林省中医药科研项目(2020087)。

摘　　要：目的:观察针刀镜联合腓骨近端截骨术治疗合并内侧间室狭窄的膝骨性关节炎的临床疗效。方法:回顾性分析自2017年5月至2020年10月诊治的20例采用针刀镜联合腓骨近端截骨术治疗的伴有内侧间室狭窄的膝骨关节炎患者。手术前后常规拍摄双膝关节负重正侧位X线片和下肢全长X线片,记录手术前后股胫角、胫股关节间隙角和视觉模拟评分(VAS)、美国特种外科医院(HSS)评分系统的改变,比较手术前后膝关节功能,记录并发症的发生情况。结果:20例均获得3个月以上随访,平均随访时间为4.5个月。VAS评分末次随访结果小于术前,差异有统计学意义(P<0.05);HSS评分末次随访结果大于术前,差异有统计学意义(P<0.05);所有患者股胫角、胫股关节间隙角末次随访结果均小于术前,差异有统计学意义(P<0.05)。结论:针刀镜联合腓骨近端截骨术治疗膝骨关节炎可以改善患肢力线,缓解疼痛症状,同时可以及时发现关节内合并其他病变情况,并采取相应治疗措施,是治疗伴有内侧间室狭窄的膝骨关节炎的安全有效的方法。Objective:To observe the clinical efficacy of acupotomy arthroscope combined with proximal fibular osteotomy on the treatment of knee osteoarthritis with medial compartment stenosis.Methods:20 cases of knee osteoarthritis with medial compartment stenosis from May 2017 to October 2020 were treated with acupotomy arthroscope combined with fibula amputation.Anteroposterior and lateral X-ray films of both knee joint bearing and full-length X-ray films of lower limbs were taken before and after surgery.Changes of tibiofemoral angle,tibiofemoral joint space angle,visual analog scale(VAS)and HSS scoring system before and after surgery were recorded,and knee function was compared before and after surgery.The incidence of complications was recorded.Results:All the 20 patients were followed up for more than 3 months with 4.5 months on average.VAS score at the last follow-up was lower than that before surgery,and the difference was statistically significant(P<0.05).The HSS score at the last follow-up was higher than that before surgery,and the difference was statistically significant(P<0.05).The final follow-up results of all patients’tibiofemoral angle and tibiofemoral joint space angle were lower than those before surgery,with statistical significance(P<0.05).Conclusion:Acupotomy arthroscope combined with proximal fibular osteotomy on the treatment of knee osteoarthritis can improve the limb strength line,relieve pain symptoms,and it can timely detect other lesions in the joint and take appropriate treatment measures.It is a safe and effective method on the treatment of knee osteoarthritis with medial compartment stenosis.

关 键 词：骨关节炎 针刀镜 腓骨近端截骨术 膝内翻 

分 类 号：R684.3[医药卫生—骨科学]