关节镜下清理术联合胫骨高位截骨术治疗中早期内翻型膝关节骨性关节炎的临床观察  

Effects of Arthroscopic Debridement Combined with High Tibial Osteotomy and Its Effect on Postoperative Pain,Imaging Parameters and Quality of Life of Patients with Early and Middle-Stage Varus Knee Osteoarthritis

作　　者：刘娜[1] 魏海强[2] 田鑫铎 王丙刚[3] LIU Na;WEI Hai-qiang;TIAN Xin-duo;WANG Bing-gang(the First Department of Joint Surgery,the Second Hospital of Tangshan City,Tangshan,Hebei 063000,China;the Third Department of Joint Surgery,the Second Hospital of Tangshan City,Tangshan,Hebei 063000,China;the Fifth Department of Traumatology,the Second Hospital of Tangshan City,Tangshan,Hebei 063000,China)

机构地区：[1]唐山市第二医院关节一科,河北唐山063000 [2]唐山市第二医院关节三科,河北唐山063000 [3]唐山市第二医院创伤五科,河北唐山063000

出　　处：《临床误诊误治》2023年第2期85-89,共5页Clinical Misdiagnosis & Mistherapy

基　　金：2021年度河北省省级科技计划项目(20210415)。

摘　　要：目的分析关节镜下清理术联合胫骨高位截骨术(HTO)对中早期内翻型膝关节骨性关节炎(OA)的疗效、术后疼痛、影像学参数及生活质量的影响。方法选取2020年1月-2021年10月收治的70例中早期内翻型OA,按照手术方式分为观察组和对照组,每组35例。观察组给予关节镜下清理术联合HTO,对照组给予关节镜下清理术。比较2组临床疗效、手术前后疼痛情况、影像学参数[髋-膝-踝角(HKA)、股胫角(FTA)、胫骨平台内翻角(TP-TSA)]、术后生活质量及术后并发症发生情况。结果治疗后观察组优良率高于对照组(P<0.05);观察组术后3个月视觉模拟评分法评分低于对照组(P<0.01);2组术后HKA、TP-TSA高于术前,FTA低于术前,观察组HKA、TP-TSA高于对照组,FTA低于对照组(P<0.01);术后6个月,观察组生活质量综合评定问卷总分高于对照组(P<0.01);2组术后随访半年均无严重并发症。结论关节镜下清理术联合HTO治疗中早期内翻型OA临床效果好,可明显改善患膝功能,矫正患肢力线,缓解术后疼痛,提高术后生活质量。Objective To analyze the effects of arthroscopic debridement combined with high tibial osteotomy(HTO)on the efficacy,postoperative pain,imaging parameters and quality of life of patients with early and middle-stage varus knee osteoarthritis(OA).Methods Seventy patients with early-stage varus OA admitted from January 2020 to October 2021 were selected and divided into observation group(n=35)and control group(n=35)according to surgical methods.The observation group was given arthroscopic debridement combined with HTO,and the control group was given arthroscopic debridement.The clinical efficacy,preoperative and postoperative pain,imaging parameters[hip knee ankle angle(HKA),femoral tibial angle(FTA),tibial plateau-tibial shaft angle(TP-TSA)],postoperative quality of life and postoperative complications were compared between the two groups.Results After treatment,the excellent and good rate of observation group was higher than that of control group(P<0.05).The visual analogue scale score of the observation group was lower than that of the control group at 3 months after surgery(P<0.01).The HKA and TP-TSA of the two groups were higher after surgery than those before surgery,and the FTA was lower than that before surgery.The HKA and TP-TSA of the observation group were higher than those of the control group,while the FTA was lower than that of the control group(P<0.01).At six months after surgery,the total score of Generic Quality of Life Inventory-74 in the observation group was higher than that in the control group(P<0.01).There were no serious complications in the two groups at 6-month follow-up.Conclusion Arthroscopic debridement combined with HTO in the treatment of early and middle-stage varus OA has a good clinical effect.It can significantly improve the function of the affected knee joint,correct the force line of the affected knee joint,effectively relieve postoperative pain and improve postoperative quality of life.

关 键 词：膝关节骨性关节炎 内翻型 关节镜下胫骨高位截骨术 膝关节功能 术后疼痛 胫骨平台内翻角 生活质量 手术后并发症 

分 类 号：R684.3[医药卫生—骨科学]