踝上截骨术治疗内翻性踝关节炎的疗效及术后膝关节变化  

Clinical effect of supramalleolar osteotomy in the treatment of varus ankle osteoarthritis andpostoperative changes of the knee

作　　者：张凯亭 莫方东 揭珂 徐镜程 邹保利 李卓 邹运璇[2] 朱永展[2] Zhang Kaiting;Mo Fangdong;Jie Ke;Xu Jingcheng;Zou Baoli;Li Zhuo;Zou Yunxuan;Zhu Yongzhan(The Eighth Clinical School of Medicine,Guangzhou University of Traditional Chinese Medicine,Guangzhou 510006,Guangdong Province,China;Department of Foot and Ankle Surgery,Foshan Hospital of Traditional Chinese Medicine,Foshan 528051,Guangdong Province,China)

机构地区：[1]广州中医药大学第八临床医学院,广东广州510006 [2]佛山市中医院足踝外科,广东佛山528051

出　　处：《中国临床解剖学杂志》2024年第6期695-699,704,共6页Chinese Journal of Clinical Anatomy

摘　　要：目的 评估踝上截骨术(supramalleolar osteotomy,SMO)治疗内翻性踝关节炎的疗效及术后同侧膝关节变化。方法 回顾2016年1月~2022年12月我院接受SMO治疗的36例(37足)患者临床资料,采用疼痛视觉模拟评分(VAS)和美国足踝外科协会评分(AOFAS)评估踝关节疗效;VAS和美国特种外科医院(HSS)膝关节评分评估膝关节临床变化,相关分级系统和影像指标评估踝和膝关节变化,并统计患者术后并发症及手术失败情况。结果 患者均获随访,平均30.05个月,末次随访时患者踝关节临床和影像指标均较术前显著改善(P<0.05);膝关节临床和影像指标较术前无明显差异(P>0.05);矫正角与髋-膝-踝角的变化具有相关性,与膝关节其它临床和影像指标变化无明显相关性。结论 SMO治疗内翻性踝关节炎疗效良好,术后短期内不会引起同侧膝关节变化。Objective To evaluate the clinical outcome of supramalleolar osteotomy(SMO)in the treatment of varus ankle osteoarthritis and the changes of ipsilateral knee joint after operation.Methods The clinical data of 36 patients(37 feet)treated with SMO in our hospital from January 2016 to December 2022 were analyzed retrospectively.The clinical efficacy of ankle joint was evaluated by pain visual analogue scale(VAS)and American Association of foot and ankle surgery score(AOFAS),and the clinical changes of knee joint were evaluated by VAS and Hospital for Special Sugery(HSS),ankle and knee joint changes were evaluated by relevant grading system and imaging indexes,and postoperative complications and operation failure were calculated.Results All patients were followed up for an average of 30.05 months.At the last follow-up,the clinical and imaging indexes of ankle were significantly improved compared with those before operation,but there was no significant difference between knee clinical and imaging indexes(P>0.05),and there was no significant correlation between correction angle and other knee clinical and imaging changes except with the changes of HKA.Conclusions SMO is effective in the treatment of varus ankle arthritis and will not cause changes in the ipsilateral knee joint in the short term after operation.

关 键 词：踝关节炎 踝上截骨术 膝关节改变 下肢力线 

分 类 号：R684.3[医药卫生—骨科学]