摘要
目的探讨关节镜清理联合胫骨高位截骨术治疗膝关节内侧单间室骨性关节炎的临床效果。方法回顾性分析2015年6月至2016年6月该院收治的26例膝关节内侧单间室骨性关节炎患者的临床资料,其中男9例,女17例;年龄50~65岁,中位年龄57.5岁;骨关节炎分期:Ⅰ期6例,Ⅱ期20例;均为单侧患肢病变。所有患者均采用关节镜清理、修复,联合开放楔形胫骨高位截骨,钢板、螺钉内固定治疗方案。随访时间为术后9~18个月,中位随访时间12个月。术前及末次随访采用美国膝关节协会评分(AKS)、X线片股胫角(FTA)及膝关节疼痛视觉模拟评分(VAS)评价临床疗效。结果26例患者均获得有效随访,围手术期切口愈合良好,未出现钢板螺钉断裂、移位,骨不愈合,下肢静脉血栓形成等并发症;术前AKS(69.1±5.6)分,FTA(186.9±2.3)°,VAS(5.46±1.35)分。术后12个月AKS(86.2±5.1)分,FTA(172.2±2.3)°,VAS(0.72±0.23)分。手术前后AKS、FTA、VAS比较,差异均有统计学意义(P<0.05)。结论应用关节镜微创清理、联合胫骨高位截骨治疗膝内侧单间室关节炎手术创伤小、并发症少,畸形矫正准确,术后恢复快,疗效确切,具有一定的临床应用价值。
Objective To discusse the treatment of medial compartment osteoarthritis of knee joint by arthroscopy and high tibial osteotomy Clinical effect.Methods Retrospective analysis of 26 patients with medial compartment osteoarthritis of knee treated in our hospital from June 2015 to June 2016.There were 9 male cases and 17 female cases.Age range from 50 to 65 with an average age of 57.5 years.Osteoarthritis in stages:Ⅰperiod 6 cases,20 casesⅡperiod.All were unilateral limb lesions.All patients were treated with arthroscopy,open wedge high tibial osteotomy,plate and screw internal fixation.Follow-up time ranged from 9 months to 18 months,with an average of 12 months.Before and at the last follow-up,the American knee association(AKS)score,X-ray femoral shin Angle(FTA)score,and visual analogue score(VAS)score were used to evaluate the clinical effects before and after knee surgery.Results All patients were followed up effectively,and the wound healing was good in perioperative period,without any complications such as plate and screw fracture,displacement,bone nonunion and venous thrombosis of lower limbs.Preoperative scores:AKS(69.1±5.6),FTA(186.9±2.3)°and VAS(5.46±1.35).Twelve months after surgery,the scores were AKS(86.2±5.1),FTA(172.2±2.3)°and VAS(0.72±0.23),The differences were statistically significant(P<0.05).Conclusion Minimally invasive arthroscopy and high tibial osteotomy were used to treat the medial knee compartment arthritis.It has the advantages of small surgical trauma,few complications,accurate correction of malformation,rapid postoperative recovery and accurate curative effect.
作者
杨瑞
YANG Rui(Department of Orthopedics,Hengshui No.4 People′s Hospital,Hengshuii,Hebei 053000,China)
出处
《重庆医学》
CAS
2020年第S01期80-82,共3页
Chongqing medicine
关键词
关节镜清理
胫骨高位截骨
膝关节内侧间室
骨关节炎
arthriscopic debridement
high tibial osteotomy
medial unicompartment of knee
osteoarthritis
