| 臧永辉,许瀚,石波,等.关节镜联合开放楔形胫骨高位截骨术治疗膝关节骨关节炎的早期效果.骨科,2020,11(5): 417-421. |
| 关节镜联合开放楔形胫骨高位截骨术治疗膝关节骨关节炎的早期效果 |
| Early results of arthroscopy combined with open-wedge high tibial osteotomy in the treatment of knee osteoarthritis |
| 投稿时间：2020-02-08 |
| DOI：10.3969/j.issn.1674-8573.2020.05.013 |
| 中文关键词: 骨关节炎，膝 截骨术，胫骨 关节镜 |
| 英文关键词: Osteoarthritis, knee Osteotomy, tibia Arthroscopy |
| 基金项目:四川省医学会骨科专项科研课题（2019SAT25） |
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| 中文摘要: |
| 目的 分析关节镜结合胫骨高位截骨术（Open-wedge high tibial osteotomy, OWHTO）治疗膝关节骨关节炎的早期效果。方法 回顾性分析2018年6月至2019年6月我科收治的因膝关节骨关节炎接受关节镜联合OWHTO手术治疗的88例（88膝）病人的临床资料。收集评价病人的美国特种外科医院膝关节评分（hospital for special surgery knee score, HSS）、疼痛视觉模拟量表（visual analogue scale, VAS）评分以及手术前后下肢全长X线片上的胫股角（femorotibial angle, FTA）、胫骨近端内侧角（medial proximal tibial angle, MPTA）等指标。结果 本组病人随访6~18个月，平均12个月。病人术后2 d、术后1个月和末次随访时的HSS分别为76.00（73.25，78.00）分、82.00（78.00，85.00）分、90.50（87.00，92.00）分，均较术前数值显著提高，两两比较，差异均有统计学意义（P均＜0.05）。术后各时间点的VAS评分均较术前显著降低，其中术后1个月和末次随访时的VAS评分均为1.00（0.00，2.00）分，显著低于术后2 d的2.00（2.00，3.00）分，差异有统计学意义（P＜0.05）。FTA由术前的179.72°±2.30°纠正至术后的172.81°±1.36°；MPTA由术前的83.35°±1.61°纠正至术后的88.47°±7.16°，手术前后数值比较，差异均有统计学意义（t=20.514，P＜0.001；t=-20.576，P＜0.001）。结论 关节镜联合OWHTO治疗膝关节骨关节炎早期在下肢力线及疼痛改善方面能取得较为满意效果，但其膝关节软骨恢复情况等需要进一步长期随访研究。 |
| 英文摘要: |
| Objective To analyze the early effect of open-wedge high tibial osteotomy (OWHTO) combined with arthroscopy in the treatment of osteoarthritis of the knee. Methods A retrospective study was conducted to select 88 patients (88 knees) admitted to the department of orthopedics of our hospital from June 2018 to June 2019 who underwent arthroscopy combined with OWHTO for osteoarthritis of the knee. Indexes such as hospital for special surgery knee score (HSS), visual analogue scale (VAS), femorotibial angle (FTA) and medial proximal tibial angle (MPTA) were collected and evaluated before and after surgery. Results All patients were followed up for 6 to 18 months, with an average of 12 months. The HSS at 2 days, 1 month after operation and last follow-up were 76.00 (73.25, 78.00), 82.00 (78.00, 85.00) and 90.50 (87.00, 92.00), respectively, which were significantly higher than those before operation, and the differences were statistically significant (P＜0.05). The VAS score at each time point after operation was significantly lower than that before operation. The VAS score at 1 month after operation and at the last follow-up was 1.00 (0.00, 2.00), which was significantly lower than that of 2 days after operation (P＜0.05). FTA was corrected from 179.72°±2.30° to 172.81°±1.36° postoperative. MPTA was corrected from 83.35°±1.61° to 88.47°±7.16° postoperatively, and the differences were statistically significant (P＜0.05 for all). Conclusion Arthroscopy combined with OWHTO in the early treatment of knee osteoarthritis can achieve satisfactory results in the improvement of lower limb alignment and pain. However, the recovery of knee cartilage needs further long-term follow-up study. |
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