文章摘要
邓迎杰,肖俞臣,方锐.胫骨高位截骨术治疗膝骨关节炎的临床疗效评估及对关节软骨再生的影响.骨科,2019,10(2):85-89
胫骨高位截骨术治疗膝骨关节炎的临床疗效评估及对关节软骨再生的影响
Clinical efficacy of high tibial osteotomy for knee osteoarthritis and its effect on articular cartilage regeneration
投稿时间:2018-11-22  
DOI:10.3969/j.issn.1674-8573.2019.02.001
中文关键词: 胫骨高位截骨术  骨关节炎,膝  软骨  治疗结果
英文关键词: High tibial osteotomy  Osteoarthritis, knee  Cartilage  Treatment outcome
基金项目:
作者单位E-mail
邓迎杰 新疆医科大学附属中医医院关节外科乌鲁木齐 830000  
肖俞臣 新疆医科大学附属中医医院关节外科乌鲁木齐 830000  
方锐 新疆医科大学附属中医医院关节外科乌鲁木齐 830000 xjfr@163.com 
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中文摘要:
      目的 评估胫骨高位截骨术(high tibial osteotomy, HTO)对膝骨关节炎病人临床症状改善及软骨再生的影响。方法 采用回顾性研究方法,选取2016年4月至2017年6月在我院确诊为膝骨关节炎并接受HTO手术的病人42例(42膝),评估上述病人手术前后的膝关节西安大略和麦克马斯特大学骨关节炎指数(the Western Ontario and McMaster Universities Arthritis Index, WOMAC)、膝关节Lysholm评分、下肢髋-膝-踝(hip-knee-ankle, HKA)角及膝关节镜下图片。结果 所有病人均手术顺利,术后无感染、骨不连、神经血管损伤等严重并发症。随访时间为(12.64±1.32)个月。病人膝关节WOMAC评分由术前的(45.26±10.27)分改善至末次随访的(0.76±0.66)分,Lysholm评分从术前的(57.93±11.98)分改善至末次随访的(95.21±2.46)分,HKA角由术前171.26°±5.20°改善至末次随访的181.26°±1.65°,手术前后的数值比较,差异均有统计学意义(P均<0.05)。术前、第2次探查关节镜图片评估显示97.62%(41/42)的膝关节出现术后软骨再生。结论 HTO治疗早、中期膝骨关节炎的疗效肯定,对病人下肢力线纠正明显,同时对膝骨关节股骨内侧髁和胫骨内侧平台的软骨再生有积极影响。
英文摘要:
      Objective To evaluate the clinical efficacy of high tibial osteotomy (HTO) for knee osteoarthritis and its effect on articular cartilage regeneration. Methods This was a retrospective study, which included 42 cases of knee osteoarthritis undergoing HTO in our hospital from April 2016 to June 2017. The Western Ontario and McMaster Universities Arthritis Index (WOMAC), Lysholm Scores, hip-knee-ankle (HKA) angle, and arthroscopic images were employed. Results All patients were successfully operated without serious complications such as infection, nonunion and neurovascular injury. The follow-up time was (12.64±1.32) months. The WOMAC score of knee joint was improved from preoperative 45.26±10.27 to 0.76±0.66 of final follow-up, Lysholm score was improved from preoperative 57.93±11.98 to 95.21±2.46 of final follow-up, and HKA angle was changed from 171.26°±5.20° to 181.26°±1.65°, there were significant differences before and after operation (P<0.05 for all). The comparison of pre- and post-operative arthroscopic images showed that cartilage regeneration occurred in 97.62% of knees. Conclusion HTO is an effective therapy for early and intermediate knee osteoarthritis, not only improving symptoms and HKA, but also promoting cartilage regeneration of medial condyle of femur and medial tibial plateau in knee joint.
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