| 邢建瑞,崔战军,范小飞,等.腓骨截骨术治疗膝骨性关节炎的临床观察.骨科,2018,9(1): 14-18. |
| 腓骨截骨术治疗膝骨性关节炎的临床观察 |
| Clinical observation on the treatment of knee osteoarthritis with fibular osteotomy |
| 投稿时间：2017-02-28 |
| DOI：10.3969/j.issn.1674-8573.2018.01.003 |
| 中文关键词: 骨关节炎 膝 内侧疼痛 腓骨 截骨术 |
| 英文关键词: Osteoarthritis Knee Medial pain Fibula Osteotomy |
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| 中文摘要: |
| 目的 观察腓骨截骨术治疗膝骨性关节炎的临床效果。方法 采用前瞻性研究方法，对2013年9月至2016年3月于我院治疗的87例（105膝）膝骨性关节炎内侧间隙疼痛病人，采用单纯腓骨截骨术治疗，其中男23例（29膝），女64例（76膝），平均年龄为63.4岁。手术前后对病人进行相应影像学评估，观察膝关节内外侧间隙高度变化；分别于术前以及术后3 d、3个月、6个月采用疼痛视觉模拟量表（visual analogue scale, VAS）、美国特种外科医院（the hospital for special surgery, HSS）膝关节评分、美国膝关节协会（the American Knee Society, AKS）综合评分系统（包含膝评分和功能评分两大部分）评估膝关节的恢复情况。结果 所有病人于术后2 d下床活动，原有膝关节内侧间隙疼痛明显减轻或消失。3例病人术后出现一过性腓浅神经损伤，5例发生腓骨小头后侧疼痛；术后3 d、3个月、6个月的VAS、HSS评分及AKS膝评分、AKS功能评分均较术前改善，除了术后3 d的AKS功能评分外，其余各项指标与术前相比，差异均有统计学意义（P均＜0.05）。术后7 d复查膝关节负重位X线片，与术前膝关节负重位X线片对比，均可见膝关节内侧间隙有不同程度的增宽。结论 腓骨截骨术具有手术切口小、创伤小、操作简单、风险低等优势，对治疗膝骨性关节炎内侧疼痛具有良好的疗效。 |
| 英文摘要: |
| Objective To observe the clinical effect of the treatment of knee osteoarthritis with fibular osteotomy. Methods A prospective study was conducted to collect 87 cases (105 knees) of knee osteoarthritis and medial knee pain from September 2013 to March 2016, including 23 males (29 knees) and 64 females (76 knees), with an average age of 63.4 years old. They have been treated with simple fibular osteotomy for the treatment of knee osteoarthritis. Before and after the operation, the patients were evaluated by the corresponding imaging, and the changes of the height of the lateral and lateral space of the knee joint were observed. The visual analogue scale (VAS), American hospital for special surgery (HSS) scores and the American knee society (AKS) systems were used to evaluate the recovery of knee joint before and after the operation (3 days, 3 months, 6 months). Results All patients took ambulation 2 days after operation, and the pain of the original medial knee joint gap disappeared or relieved obviously. Three cases got transient peroneal superficial peroneal nerve injury after operation, and 5 cases suffered from fibular head back pain. The scores of VAS, HSS, and AKS knee and function were improved. Except the AKS function score at 3rd day after operation, the remaining showed statistically significant difference from those before the operation (P＜0.05 for all). The X-ray re-examination of the knee joint at the bearing position on the postoperative day (POD) 7 revealed the widened medial space of the knee joint as compared with that before operation. Conclusion The fibular osteotomy has the advantages of small incision, less trauma, good effect, simple operation and low risk. It has a good effect on the treatment of medial pain of knee osteoarthritis. |
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