膝关节镜技术联合胫骨高位截骨治疗膝内侧骨性关节炎的疗效  

Curative effect of knee arthroscopy combined with high tibial osteotomy on medial knee osteoarthritis and its influences on perioperative indexes and postoperative complications

作　　者：张世松 崔丽红[1] 单淑兰[1] 刘焕 于国胜[1] ZHANG Shisong;CUI Lihong;SHAN Shulan;LIU Huan;YU Guosheng(The Fourth Department of Orthopedics,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou 061000,Hebei,China)

机构地区：[1]河北省沧州中西医结合医院骨四科,河北沧州061000

出　　处：《西部医学》2023年第8期1188-1192,共5页Medical Journal of West China

基　　金：沧州市重点研发计划指导项目(213106099)。

摘　　要：目的 探讨膝关节镜技术联合胫骨高位截骨(HTO)治疗膝内侧骨性关节炎疗效及对围术期指标和术后并发症的影响。方法 回顾性分析我院2016年1月—2021年6月88例膝内侧骨性关节炎患者的临床资料,根据手术方式不同分为观察组(n=48)及对照组(n=40)。对照组采用膝关节镜技术治疗,观察组采用膝关节镜技术联合HTO治疗。比较两组围术期指标、手术前后日常生活活动能力、疼痛程度、膝关节功能、炎症因子、并发症、满意度。结果 观察组术中出血量、手术时间均高于对照组,住院时间短于对照组(P<0.05);观察组术后日常生活活动能力量表(ADL)评分高于对照组,视觉疼痛模拟评分(VAS)低于对照组(P<0.05);观察组术后膝关节活动度(ROM)、Lysholm评分、HSS评分高于对照组(P<0.05);观察组术后膝关节液TNF-α、IL-6水平低于对照组(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05);术后随访6个月时,观察组满意度自评分高于对照组(P<0.05)。结论 在膝内侧骨性关节炎的治疗中,膝关节镜技术联合HTO具有良好的疗效,能缩短住院时间,提高日常生活活动能力,减轻术后疼痛,改善膝关节功能,缓解炎症反应,且术后并发症少,患者满意度高。Objective To explore the curative effect of knee arthroscopy combined with high tibial osteotomy(HTO)on medial knee osteoarthritis and its influences on perioperative indexes and postoperative complications.Methods A retrospective analysis was performed on the clinical data of 88 patients with medial knee osteoarthritis in the hospital from January 2016 to June 2021.According to different surgical methods,they were divided into study group(n=48)and control group(n=40).The control group was treated with knee arthroscopy,while study group was additionally treated with HTO.The perioperative indexes,activities of daily living,pain degree,knee function,inflammatory factors,complications and satisfaction before and after surgery were compared between the two groups.Results The intraoperative blood loss and operation time in study group were higher than those in control group,and hospitalization time was shorter than that in control group(P<0.05).After surgery,score of activity of daily living scale(ADL)in study group was higher than that in control group,and score of visual analogue scale(VAS)was lower than that in control group(P<0.05).After surgery,knee range of motion(ROM),Lysholm and HSS scores in study group were higher than those in control group(P<0.05),and levels of tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in knee joint fluid were lower than those in control group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).At 6 months after postoperative follow-up,self-score of satisfaction in study group was higher than that in control group(P<0.05).Conclusion In the treatment of medial knee osteoarthritis,knee arthroscopy combined with HTO has good curative effect,which can shorten hospitalization time,improve activities of daily living,alleviate postoperative pain,improve knee function and relieve inflammatory response,with fewer postoperative complicationsand higher satisfaction.

关 键 词：膝内侧骨性关节炎 膝关节镜技术 胫骨高位截骨 围术期指标 并发症 

分 类 号：R684[医药卫生—骨科学]