摘要
目的探讨腓骨近端段切术对严重膝关节骨性关节炎的疗效是否优于非手术治疗。方法采用前瞻性研究32例（42膝）严重膝关节骨性关节炎,分为2组,处理组10例（20膝）行腓骨近端段切术,对照组22例（22膝）行封闭＋玻璃酸钠注射治疗。观察2组治疗后3、6、12个月的临床疗效,并采用SPSS 17.0进行统计学分析。结果 2组治疗结束后第3、6、12个月接受随访。处理组切口均一期愈合,2膝出现肌间血肿,经热敷后吸收;1膝腓浅神经损伤,未予特殊处理,3个月后恢复。对照组没有出现并发症。2组治疗后3个月疗效差异无统计学意义（P〉0.05）,但治疗后6、12个月处理组疗效优于对照组,差异有统计学意义（P〈0.05）。治疗后12个月时2组疗效差距最大,把显效和优秀合并为有效,治疗12个月时处理组有效率明显高于对照组[RR=2.34,χ2CMH=10.408,P=0.001 5,95%CI（1.30,4.19）]。结论单纯腓骨上端段切术是治疗严重膝关节骨性关节炎的有效方法,手术操作简单,创伤小,可有效缓解膝关节外侧软组织张力,减轻疼痛,患者可即刻负重行走。
Objective To explore whether the clinical effect of fibular proximal bone resection is superior to the conservative management in treatment of the serious knee joint osteoarthritis. Methods Forty two knees with serious knee joint osteoarthritis were divided into two groups. Twenty knees with fibular proximal bone resection were regarded as the treatment group while the other 22 knees with local blocking and intra-articular injection of sodium hyaluronate were regarded as the control group. The clinical effects of the two groups in the third, sixth and twelfth month after treatment were observed. The data of effects were analyzed by SPSS 17.0. Results All the patients of the two groups were follwed up in the third, sixth and twelfth month after end-of-treatment. In the treatment group, all the incisions had primary healing, the intramascular hematoma appeared in two knees which was absorbed by hot compress and one knee was complicated by superficial peroneal nerve injury which recovered three months later without any special treatment. In the control group there was no complications. There was no significant difference in the third month outercomes between the two groups（P〉0.05）, while there were significant differences in the sixth and twelfth month outercomes between the two groups（P〈0.05）. The difference was most obvious in the twelfth month aftter treatment. The effctive rate of the treatment group was superior obviouly to that of the control group[RR =2.34,χ2CMH=10.408,P =0.001 5,95%CI（1.30,4.19）]. Conclusion The fibular proximal bone resection is an effective method to treat the serious knee joint osteoarthritis. Its surgical procedure is very simple with less injury. It can relax the tension of the lateral knee soft tissue and relieve the pain effectively. The patients can walk bearing weight immediately after operation.
出处
《中国骨与关节损伤杂志》
2015年第6期595-598,共4页
Chinese Journal of Bone and Joint Injury
基金
国家自然科学基金青年基金项目(71403155)
关键词
严重膝关节骨性关节炎
腓骨近端段切术
队列研究
Serious knee joint osteoarthritis
Fibular proximal bone resection
Cohort study
