关节镜联合胫骨内侧开放截骨术治疗膝关节骨关节炎的临床疗效及对炎症因子的影响  

Clinical efficacy of arthroscopy combined with medial tibial open osteotomy in the treatment of knee osteoarthritis and its effect on inflammatory factors

作　　者：马小松[1] 张华 邬良平 李朋斌[1] 西立峰[1] MA Xiaosong;ZHANG Hua;WU Liangping;LI Pengbin;XI Lifeng(Department of Gynaecology,Yellow River Sanmenxia Hospital,Sanmenxia,He'nan,742000,China)

机构地区：[1]黄河三门峡医院骨科,河南三门峡472000

出　　处：《当代医学》2024年第7期133-136,共4页Contemporary Medicine

摘　　要：目的探讨关节镜联合胫骨内侧开放截骨术治疗膝关节骨关节炎(KOA)的临床疗效及对炎症因子的影响。方法选取2017年12月至2020年12月黄河三门峡医院收治的32例KOA患者作为研究对象,均行关节镜联合胫骨内侧开放截骨术治疗,比较患者治疗前及治疗后1、3、6、12个月疼痛评分(VSA)及西安大略和曼彻斯特大学骨关节炎(WOMAC)评分及白细胞介素(IL)-1β,IL-6及肿瘤坏死因子-α(TNF-α)水平。结果治疗前及治疗后1、3、6、12个月,VAS、WOMAC评分及IL-1β、IL-6、TNF-α水平呈逐渐下降趋势,差异有统计学意义(P<0.05)。患者术前下肢全长片显示下肢力线明显内翻,术后X线片检查示截骨线及截骨处外侧合页良好,内固定钛板及螺钉位置良好;内固定取出术后X线片显示,胫骨近端内侧角增大,下肢力线恢复正常。结论关节镜联合胫骨内侧开放截骨术治疗KOA效果显著,可改善膝关节功能,减轻患者疼痛,降低关节液中炎症因子水平,值得临床推广应用。Objective To investigate the clinical efficacy of arthroscopy combined with medial tibial open osteotomy in the treatment of knee os-teoarthritis(KOA)and its effect on inflammatory factors.Methods 32 patients with KOA admitted to SYellow River Sanmenxia Hospital from De-cember 2017 to December 2020 were selected as the research subjects.All patients were treated with arthroscopy combined with medial tibial open osteotomy,visual analogue scale(VSA),Western Ontario and McMaster university osteoarthritis index(WOMAC)score and interleukin(IL)-1β,IL-6,tumor necrosis factor-α(TNF-α)levels were compared before treatment and 1,3,6 and 12 months after treatment.Results Before treatment and 1,3,6 and 12 months after treatment,VAS,WOMAC scores and IL-1β,IL-6 and TNF-αlevels showed the gradual downward trend,and the differ-ences were statistically significant(P<0.05).The preoperative full-length film of the lower limb showed obvious varus of the lower limb force line;the postoperative X-ray examination showed that the osteotomy line and the lateral hinge of the osteotomy site were good,and the internal fixation ti-tanium plate and screw were in good position.X-ray films after internal fixation removal showed that the medial angle of the proximal tibia increased and the lower limb force line returned to normal.Conclusion Arthroscopy combined with medial tibial open osteotomy is effective in the treatment of KOA,it can improve knee joint function,relieve pain and reduce the level of inflammatory factors in synovial fluid,and is worthy of clinical pro-motion and application.

关 键 词：关节镜 胫骨截骨术 膝关节骨关节炎 炎症因子 

分 类 号：R687.3[医药卫生—骨科学]