| 弋卓君,许瀚,石波,等.胫骨高位截骨术后不同力线位置的临床疗效比较.骨科,2021,12(1): 40-44. |
| 胫骨高位截骨术后不同力线位置的临床疗效比较 |
| Comparison of the clinical effectiveness of high tibial osteotomy with different positions of weight bearing axis |
| 投稿时间：2020-06-10 |
| DOI：10.3969/j.issn.1674-8573.2021.01.008 |
| 中文关键词: 骨关节炎，膝 截骨术，胫骨 下肢力线 临床疗效 |
| 英文关键词: Osteoarthritis, knee Osteotomy, tibia Lower extremity force line Clinical effect |
| 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 分析胫骨高位截骨术（high tibial osteotomy，HTO）后不同力线位置病例的临床疗效。方法 回顾性分析2018年6月至2019年6月于我院骨科接受HTO的60例病人的临床资料，根据HTO术后患侧下肢力线（weight-bearing axis，WBA）位置的不同将其分为两组，A组WBA位于胫骨平台从内到外的50%~60%，B组WBA位于胫骨平台从内到外的62%~66%，每组各30例。收集并分析病人美国特种外科医院（Hospital for Special Surgery，HSS）膝关节评分、疼痛视觉模拟量表（visual analogue scale，VAS）评分、胫股角（femorotibial angle，FTA）、胫骨近端内侧角（medial proximal tibial angle，MPTA）等指标。结果 全部病人均获得随访，随访时间为3~6个月，平均4.5个月。两组术前，术后第2天，术后1、3个月，HSS评分均逐渐增加，VAS评分均逐渐降低，差异均有统计学意义（P均＜0.05）。两组间术前，术后第2天，术后1、3个月各个时间段的HSS评分、VAS评分比较，差异均无统计学意义（P均＞0.05）。A组术后MPTA、FTA分别为88.47°±1.74°、177.53°±2.11°，B组为90.03°±2.16°、176.93°±2.77°，两组间MPTA的差异有统计学意义（P＜0.05），FTA的差异无统计学意义（P＞0.05）。结论 HTO术后WBA范围在50%~60%和62%~66%的病人都能获得良好的膝关节功能改善和明显的疼痛缓解，两组病人早中期临床疗效无明显差异，远期疗效需要进一步观察研究。 |
| 英文摘要: |
| Objective To analyze the clinical effectiveness of high tibial osteotomy (HTO) in patients with different positions of weight bearing axis (WBA). Methods The clinical data of 60 patients who received HTO in orthopedics department of our hospital from June 2018 to June 2019 were retrospectively analyzed. According to the locations of WBA, 30 patients were selected from the tibial plateau from 50% to 60% (group A: 50%≤WBA≤60%) and 62% to 66% (group B: 62%≤WBA≤66%). The Hospital for Special Surgery (HSS) knee score, visual analogue scale (VAS), femorotibial angle (FTA), and medial proximate tibial angle (MPTA) of patients were collected and analyzed. Results All patients were followed up for 3 to 6 months, with an average of 4.5 months. Before and 2 days, 1 month and 3 months after operation, HSS score increased and VAS score decreased in both groups, and all the differences were statistically significant (all P＜0.05). There were no statistically significant differences between the two groups in the HSS and VAS score before and 2 days, 1 month and 3 months after operation (all P＞0.05). The postoperative MPTA and FTA in group A were 88.47°±1.74° and 177.53°±2.11° respectively, and those in group B were 90.03°±2.16° and 176.93°±2.77° respectively. There was significant difference in MPTA between the two groups (P＜0.05), but there was no significant difference in FTA (P＞0.05). Conclusion After HTO, patients with lower limb force in the range of 50%-60% and 62%-66% can achieve good knee function improvement and significant pain relief, but there is no significant difference between them in early and middle stage, so further observation and study are needed for long-term comparison. |
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