摘要
目的探讨腓骨截骨联合关节镜微骨折治疗膝关节骨性关节炎的临床疗效。方法将2015年6月至2018年6月收治的100例膝关节骨性关节炎患者分为观察组和对照组,各50例。观察组采用腓骨截骨联合关节镜微骨折治疗;对照组仅采用关节镜微骨折治疗。比较两组的疗效,采用美国特种外科医学(HSS)评估临床症状的变化,采用视觉模拟评分法(VAS)评估疼痛程度。于术前和术后12个月,检测并比较两组患者膝关节液基质金属蛋白酶(MMP)-9、白细胞介素(IL)-6、肿瘤坏死因子(TNF)-α水平,自主屈曲至90°、直腿抬高的时间。结果观察组总有效率稍高于对照组,但差异无统计学意义(94. 00%vs 82. 00%,P>0. 05)。治疗后两组的HSS评分较治疗前升高,VAS评分较治疗前降低(P<0. 05);且观察组治疗后的HSS评分高于对照组,VAS评分低于对照组,差异有统计学意义(P<0. 05)。治疗后两组关节液MMP-9、IL-6、TNF-α水平较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0. 05)。观察组膝关节自主屈曲至90°、直腿抬高的时间显著低于对照组,差异有统计学意义(P<0. 01)。结论腓骨截骨联合关节镜微骨折治疗膝关节骨性关节炎的疗效确切,可提高关节功能,减轻疼痛,促进关节恢复。
Objective To investigate the clinical effect of fibular osteotomy combined with arthroscopic micro-fracture in the treatment of knee osteoarthritis. Methods A total of 100 patients with knee osteoarthritis treated from June 2015 to June 2018 were divided into observation group and control group(n = 50,each). The fibular osteotomy combined with arthroscopic microfracture was conducted in observation group,while the arthroscopic microfracture alone was performed in control group. The changes in clinical symptoms were assessed by American Hospital for Special Surgery Score(HSS),and the degree of pain was evaluated by visual analogue scale(VAS) to compare the curative effects between two groups. The levels of matrix metalloproteinase(MMP)-9,interleukin(IL)-6 and tumour necrosis factor-α(TNF-α) in knee joint fluid were detected before and 12 months after operation,and the time of active flexion to 90° and straight leg elevation were recorded in both groups. Results The curative effect in observation group was slightly higher than that in control group(94. 00% vs 82. 00%,P >0. 05). After treatment,HSS increased,and VAS decreased significantly compared with those before treatment in two groups(P< 0. 05);HSS in observation group was higher than that in control group,and VAS was lower than that in control group statistically(P< 0. 05). After treatment,the levels of MMP-9,IL-6 and TNF-α in the synovial fluid decreased significantly compared with those before treatment in two groups(P< 0. 05) and were statistically lower in observation group than those in control group(P< 0. 05). The time for active flexion to 90° and straight leg elevation in observation group was significantly shorter than that in control group(P< 0. 01). Conclusion Fibular osteotomy combined with arthroscopic micro-fracture is effective in the treatment of knee osteoarthritis,which can improve joint function,relieve pain and promote joint recovery.
作者
赵士好
杨少坤
许效坤
肖爱华
ZHAO Shi-hao;YANG Shao-kun;XU Xiao-kun;XIAO Ai-hua(Department of Orthopaedics,Cangzhou People's Hospital,Cangzhou,Hebei 061000,China)
出处
《中国临床研究》
CAS
2020年第2期194-197,共4页
Chinese Journal of Clinical Research
基金
河北省沧州市科技支撑计划项目(172302071)~~
