个性化开放楔形胫骨高位截骨术治疗膝骨关节炎的临床研究  

Clinical Study on Personalized Open Wedge High Tibial Osteotomy on the Treatment of Knee Osteoarthritis

作　　者：宋忱 张万喜 SONG Chen;ZHANG Wanxi(Department of Orthopedics,The Second Hospital of Tangshan,Tangshan 063000,Hebei China)

机构地区：[1]唐山市第二医院骨科,河北唐山063000

出　　处：《中国中医骨伤科杂志》2023年第10期29-34,共6页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:探讨个性化开放楔形胫骨高位截骨术治疗膝骨关节炎的临床疗效。方法:以2019年10月至2021年10月收治的94例膝骨关节炎患者作为研究对象,根据目标力线矫正点选择原则的不同将患者分为观察组(根据关节镜探查的Outbridge分级结果进行个性化力线的选择,47例)和对照组(统一选择Fujisawa点,47例)。通过多准则决策模型分析个性化目标力线校正点治疗的优势。结果:观察组患者的胫骨平台后倾角(PTS)、胫骨近端内侧角(MPTA)、美国特种外科医院(HSS)膝关节评分及膝关节活动度均明显上升,矫正满意度更高,差异有统计学意义(P<0.05);术后胫股角(FTA)、疼痛视觉模拟量表(VAS)评分更低,并发症和不良反应的发生率更低,差异有统计学意义(P<0.05)。个性化开放楔形胫骨高位截骨术治疗膝骨关节炎,选择不同目标力线矫正点对矫正患者下肢力线,调节胫股角和胫骨近端内侧角,改善患者膝骨关节炎程度,提高膝关节活动度以及矫正满意度方面更具有优势,且并发症及不良反应发生率更低。观察组的效益高、风险高,效益-风险总值(66)高于对照组(55)。结论:个性化开放楔形胫骨高位截骨术治疗膝骨关节炎的疗效优于固定力线矫正点,矫正结果更好,更利于患者术后恢复,患者的矫正满意度更高。Objective:To explore clinically efficacy of personalized open wedge high tibial osteotomy on the treatment of knee osteoarthritis.Methods:94 patients with knee osteoarthritis from October 2019 to October 2021 were taken as research objects.According to the different correction points of the target force line,patients were divided into personalized force line groups(personalized force line selection based on Outbridge grading results from arthroscopic exploration,47 cases)and fixed force line groups(unified selection of Fujisawa points,47 cases).The advantages of personalized target force line correction point treatment were analyzed through multi-criteria decision model.Results:In the observation group,the tibial platform caster posterior tibial slope(PTS),medial proximal tibial angle(MPTA),knee joint score of American Hospital of Special Surgery(HSS)and knee joint range of motion were significantly increased and have a higher correction satisfaction(P<0.05).Postoperative scores of femoral tibial angle(FTA)and visual analogue scale(VAS)of pain were lower.And the incidence of complications and adverse reactions was lower(P<0.05).Personalized open wedge high tibial osteotomy has more advantages in correcting the lower limb force line of patients,adjusting the FTA and MPTA,improving the degree of knee osteoarthritis of patients,improving the range of motion of knee joints and satisfaction with correction.The incidence of complications and adverse reactions was lower.The observation group had high benefit and high risk.The total benefit risk value of the observation group(66)was higher than that of the control group(55).Conclusion:Personalized open wedge high tibial osteotomy is better than fixed force line correction points on the treatment of knee osteoarthritis.The result of correction is better,which is more conducive to the postoperative recovery of patients,and the satisfaction of patients with correction is higher.

关 键 词：个性化目标力线矫正点 关节镜 开放楔形胫骨高位截骨术 膝骨关节炎 安全性 有效性 

分 类 号：R684.3[医药卫生—骨科学]