医用臭氧关节腔内注射与胫骨高位截骨术联合治疗膝骨性关节炎的临床疗效研究  

Clinical effect of high tibial osteotomy combined with intraarticular ozone injection for knee osteoarthritis

作　　者：乔宁宁 任新华 关晓瑞 成飞 李志强 QIAO Ningning;REN Xinhua;GUAN Xiaorui;CHENG Fei;LI Zhiqiang(Department of Orthopedics,541 General Hospital,Yuncheng 043800,China;Department of Joint Surgery,Yuncheng Central Hospital,Yuncheng 043800,China)

机构地区：[1]五四一总医院骨科,山西省运城市043800 [2]运城市中心医院关节外科,山西省运城市043800

出　　处：《实用老年医学》2024年第10期1016-1019,1024,共5页Practical Geriatrics

摘　　要：目的 探讨医用臭氧关节腔内注射与胫骨高位截骨术(HTO)联合治疗膝骨性关节炎(KOA)的临床疗效。方法 选取2020年1月至2022年1月五四一总医院收治的84例KOA病人,随机分为A组(n=42)和B组(n=42),A组仅进行HTO治疗,B组在HTO术前加用医用臭氧关节腔内注射治疗。比较2组手术情况、疼痛程度、膝关节功能、步态指标及术后并发症发生情况。结果 与术前相比,2组术后VAS评分、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分及双支撑相水平逐渐降低(P<0.05),且B组低于A组(P<0.05)。与术前相比,2组术后胫骨近端内侧角(MPTA)均缩小(P<0.05),但B组大于A组(P<0.05)。与术前相比,2组术后膝关节功能评分、关节活动范围(ROM)、步长、步速、步频均增加(P<0.05),且B组高于A组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 HTO术前对KOA病人采用医用臭氧关节腔内注射治疗,能进一步提高病人的步态指标和膝关节功能,缓解病人的疼痛,安全性高。Objective To investigate the clinical effect of combined treatment of intraarticular injection of medical ozone and high tibial osteotomy(HTO)for knee osteoarthritis.Methods A total of 84 elderly patients with KOA admitted to 541 General Hospital from January 2020 to January 2022 were randomly divided into group A(n=42)and group B(n=42).Group A was treated with HTO,and group B was treated with intraarthroscopic injection of medical ozone before HTO.The operation status,pain degree,knee joint function,gait index and postoperative complications were recorded and compared between the two groups.Results The scores of visual analogue scale(VAS)and Western Ontario and McMaster University Osteoarthritis Index(WOMAC)and the biphase levels in the two groups were gradually decreased after surgery(P<0.05),and especially in group B(P<0.05).The medial proximal tibial angle(MPTA)was reduced in both groups after the surgery(P<0.05),especially in group A(P<0.05);The knee function score,joint range of motion(ROM),step length,step speed and step frequency were increased in both groups after surgery(P<0.05),especially in group B(P<0.05).There was no significant difference in the incidence rate of adverse reactions between the two groups(P>0.05).Conclusions Preoperative treatment with medical ozone intraarticular injection can further improve the gait index and knee joint function in the patients with KOA,relieve the patients’pain,and have high safety.

关 键 词：医用臭氧 关节腔内注射 胫骨高位截骨术 膝骨性关节炎 

分 类 号：R684.3[医药卫生—骨科学]