腓骨近端截骨术治疗膝骨关节炎的疗效  

The effect of proximal fibular osteotomy in the treatment of knee osteoarthritis

作　　者：刘道兵[1] 王荣田 李䶮 王均玉[1] 何海军[1] 陈卫衡 LIU Dao-bing;WANG Rong-tian;LI Yan;WANG Jun-yu;HE Hai-jun;CHEN Wei-heng(SectionⅢ,Dept of Bone and Joint,Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China)

机构地区：[1]中国中医科学院望京医院骨关节三科,北京100102 [2]北京中医药大学第三附属医院微创关节科,北京100029

出　　处：《临床骨科杂志》2022年第5期639-643,共5页Journal of Clinical Orthopaedics

基　　金：国家卫健委重大新药创制专项课题(编号:2019ZX09731-002)。

摘　　要：目的 探讨腓骨近端截骨术治疗膝骨关节炎的疗效。方法 将40例膝骨关节炎患者根据随机数字表法分为观察组(采用腓骨近端截骨术治疗,20例)和对照组(采用单纯膝关节腔灌洗治疗,20例)。记录疼痛VAS评分、膝关节功能Lysholm评分,摄膝关节X线片复查比较术后6个月与术前内侧关节间隙及软骨下骨质密度改变情况。结果 患者均获得6个月随访。疼痛VAS评分:术后1、3个月两组比较差异均无统计学意义(P> 0.05),术后6个月观察组低于对照组(P<0.05)。Lysholm评分:术后1个月两组比较差异无统计学意义(P> 0.05),术后3、6个月观察组均高于对照组(P<0.05)。术后6个月与术前膝关节X线片比较显示,内侧间隙及软骨下骨质密度改变情况观察组优于对照组(P<0.05)。结论 腓骨近端截骨术治疗膝骨关节炎疗效良好,能有效缓解疼痛、改善关节功能,联合膝关节腔灌洗效果更好。Objective To investigate the effect of proximal fibular osteotomy in the treatment of knee osteoarthritis(KOA).Methods The 40 patients with KOA were randomly divided into observation group(proximal fibular osteotomy treatment, 20 cases) and control group(pure knee cavity lavage treatment, 20 cases). Pain VAS, Lysholm score of the knee function were recorded. Knee X-ray film reexamination was used to compare the changes of medial joint space and subchondral bone density between 6 months after surgery and before surgery.Results All patients were followed up for 6 months. Pain VAS:at 1,3 months after surgery,there was no significant difference between the two groups(P> 0. 05);at six months after operation, the observation group was lower than the control group(P<0. 05). Lysholm score:there was no statistically significant difference between the two groups at 1 month after surgery(P> 0. 05);the observation group was higher than the control group at 3,6 months after operation(P< 0. 05). Comparison of knee X-ray film of the preoperation and postoperative 6 months confirmed that the changes of medial space and subchondral bone density were better in the observation group than the control group(P< 0. 05).Conclusions In the treatment of KOA,proximal fibular osteotomy can effectively relieve pain and improve joint function,which combine with the joint cavity lavage treatment have better efficacy.

关 键 词：腓骨近端截骨术 关节腔灌洗 膝骨关节炎 

分 类 号：R684.3[医药卫生—骨科学] R687.3[医药卫生—外科学]