中晚期踝关节炎治疗方案选择原则及治疗方法的研究进展  

Research progress in selection principles and treatment methods for mid-to-late stage ankle arthritis

作　　者：刘恒宇 阮耀宽 姜振德 张汉阳[1] 牛宇璇 李璞 梅南 常非[1] LIU Hengyu;RUAN Yaokuan;JIANG Zhende;ZHANG Hanyang;NIU Yuxuan;LI Pu;MEI Nan;CHANG Fei(Department of Foot and Ankle Surgery,Second Hospital,Jilin University,Changchun 130041,China;School of Sports and Health Technology Institute,Jilin Sport University,Changchun 130022,China;Department of Orthopedics,Nara Medical University,Nara 634-8522,Japan)

机构地区：[1]吉林大学第二医院足踝外科,吉林长春130041 [2]吉林体育学院运动与健康技术学院,吉林长春130022 [3]奈良医科大学矫形外科,日本奈良634-8522

出　　处：《吉林大学学报(医学版)》2025年第1期266-274,共9页Journal of Jilin University:Medicine Edition

基　　金：科技部国家重点研发计划项目(2022YFE0107700)。

摘　　要：中晚期踝关节炎是一种在临床上极为常见的慢性退行性疾病,其特征为明显的软骨退化和软骨下骨硬化,同时伴随关节周围骨赘的生成,常导致关节畸形。这一病症导致患者在行走时出现剧烈疼痛,活动受到严重限制,影响其生活质量。近年来,随着医疗水平的不断提升,针对中晚期踝关节炎的治疗方法呈现出多样化的发展趋势。非手术治疗方法主要包括限制活动、矫形支具、口服非甾体抗炎药(NSAIDs)以及胫距关节腔内注射;手术治疗方法主要包括关节牵张成形术、关节周围截骨术、全踝关节置换术以及踝关节融合术;组织工程治疗作为一种新兴的方法,也备受关注。本文系统性地综述中晚期踝关节炎的传统治疗、非手术治疗、手术治疗和组织工程治疗等多种治疗方案的选择原则及研究进展。通过深入分析各治疗方法的基本原理和优劣势,结合最新研究成果在临床的应用效果,构建科学完整的临床决策参考体系,为医生和患者提供更清晰全面的治疗选择,从而有效提高治疗效果并改善患者的生活质量。Mid-to-late stage ankle arthritis is a chronic degenerative disease that is extremely common in clinical practice.It is characterized by significant cartilage degeneration and subchondral bone sclerosis,accompanied by the formation of osteophytes around the joint,often leading to joint deformity.This condition causes severe pain in the patients during walking,severely restricts their activities,and affects their qualities of life.In recent years,with the continuous improvement of medical standards,the treatment methods for mid-to-late stage ankle arthritis have shown a diversified development trend.Non-surgical treatments primarily include activity restriction,orthotic devices,oral non-steroidal anti-inflammatory drugs(NSAIDs),and intra-articular injections of the talocrural joint.The surgical treatments primarily include joint distraction arthroplasty,periacetabular osteotomy,total ankle arthroplasty,and ankle arthrodesis.Tissue engineering therapy,as an emerging method,has also received considerable attention.This article systematically reviewed the selection principles and research progress of various treatment options for mid-to-late stage ankle arthritis,including traditional treatments,non-surgical treatments,surgical treatments,and tissue engineering treatments.By deeply analyzing the basic principles and advantages and disadvantages of each treatment method,and combining the latest research findings on clinical outcomes,a scientific and comprehensive clinical decision-making reference system was constructed to provide clearer and more comprehensive treatment choices for both doctors and patients,thereby effectively improving treatment outcomes and enhancing the quality of life for the patients.

关 键 词：中晚期踝关节炎 非手术治疗 手术治疗 组织工程治疗 踝关节融合术 临床决策 

分 类 号：R684.3[医药卫生—骨科学]