摘要
目的比较腓骨近端截骨术和胫骨高位截骨术治疗早期膝关节骨关节炎(KOA)的临床疗效。方法回顾性分析自2015年4月至2015年8月山西省临汾市第四人民医院骨科行腓骨近端截骨术(n=30)和胫骨高位截骨术(n=30)治疗早期KOA患者共60例,男29例(48%),女31例(52%);年龄38~75岁,平均(56±7)岁。所有患者术前及末次随访时行双膝关节下肢力线X线片和MRI检查,分别在术前、术后3个月、6个月比较两组患者的胫股角、疼痛视觉模拟评分(VAS)、美国特种外科医院(HSS)膝关节评分及美国膝关节协会评分(KSS)评价膝关节功能。结果 60例患者均获得随访,随访时间为1~6个月,平均(3.8±1.5)个月。腓骨近端截骨组患者的手术时间[(26±5)min]和术中出血量[(24±8)ml]均少于胫骨高位截骨组[(67±11)min、(85±10)ml],差异具有统计学意义(t=13.246,t=16.753,P<0.01)。与胫骨高位截骨组相比,腓骨近端截骨组患者在术后3个月时HSS、KSS评分及胫股角度均较高,差异均有统计学意义(F=6.884,F=6.665,F=7.974,P<0.01);两组患者术后3个月与术后6个月各指标较术前均获得改善,差异具有统计学意义(P<0.01)。结论腓骨近端截骨术和胫骨高位截骨术治疗早期KOA均可有效减轻患者疼痛、改善膝关节功能及减小胫股角度,但腓骨近端截骨术具有起效快创伤小、手术时间短等优点。
Objective To compare the effect of the proximal fibular osteotomy and high tibial osteotomy in treating early knee osteoarthritis (KOA). Methods A retropspective study was performed in 60 cases of knee osteoarthritis (KOA) who underwent proximal fibular osteotomy (PFO) and high tibial osteotomy(HTO) from April 2015 to August 2015. There were 29 males (48%), 31 females (52%), the average age was of 57±8 years (range, 38-75 years). They were divided into PFO group (n=30) and high HTO group (n=30), and receieved X- ray and MRI examination before surgery and at the last follow- up. The visual analogue score(VAS), hospital for Special Surgery knee score (HSS), society knee score (KSS) and femur- tibia angle (FTA)were compared at the pre- operation and the 3rd, the 6th month after the surgery between these two groups.Results Sixty cases had follow-up from 1 to 6 months, with an average of (3.8±1.5) months. The operation time in PFO group [(26±5) min]was shorter thanHTOgroup [(67±11) min] with statistical significant (t=13.246,P<0.01). Blood loss in PFO group [(24 ± 8) ml] was less than HTO group [(85 ± 10) ml] with statistical significant (t=13.246, t=16.753, P<0.01). Compared with HTO group, the HSS, KSS and FTA were all higher than PFO group at the 3rd month postoperatively (F=6.884, F=6.665, F=7.974, P<0.05). Compared with preoperation,theVAS,HSSknee score,KSSandTFAhad improvement significantly at the 3rd month and 6th month postoperation in each group (P<0.01). Conclusion PFO and HTO can effectively relieve pain, improve the function and decrease theTFA.ThePFOhas good early-stage effect with little trauma and fewer complications.
作者
王文革
李仕臣
赵艳东
杨秋荟
Wang Wenge;Li Shichen,;Zhao Yandong;Yang Qiuhui(Department of Orthopaedic,The Forth People's Hospital of Linfen, Linfen 041000, China)
出处
《中华老年骨科与康复电子杂志》
2017年第2期91-96,共6页
Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)
基金
山西省医学重点学科项目资金(GL201536)
关键词
膝关节
骨关节炎
腓骨
截骨术
Knee joint
Osteoarthritis
Fibula
Osteotomy
