| 胫骨高位嵌插截骨与传统高位截骨治疗高龄屈曲型膝内侧间隙骨关节炎的对比研究 |
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| 作者 | Author | 单位 | Address | E-Mail |
| 韩明涛 |
HAN Ming-tao |
文登整骨医院骨伤研究所,山东 文登 264400 |
Institute of Orthopaedics and Traumatology,Shandong Wendeng Orthopaedic and Traumatic Hospital,Wendeng 264400,Shandong,China |
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| 王飞 |
WANG Fei |
文登整骨医院骨伤研究所,山东 文登 264400 |
Institute of Orthopaedics and Traumatology,Shandong Wendeng Orthopaedic and Traumatic Hospital,Wendeng 264400,Shandong,China |
wangfei8150569sina.com |
| 孙晋客 |
SUN Jin-ke |
文登整骨医院骨伤研究所,山东 文登 264400 |
Institute of Orthopaedics and Traumatology,Shandong Wendeng Orthopaedic and Traumatic Hospital,Wendeng 264400,Shandong,China |
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| 谭振华 |
TANG Zhen-hua |
文登整骨医院骨伤研究所,山东 文登 264400 |
Institute of Orthopaedics and Traumatology,Shandong Wendeng Orthopaedic and Traumatic Hospital,Wendeng 264400,Shandong,China |
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| 期刊信息：《中国骨伤》2010年，第23卷，第2期，第107-110页 |
| DOI：10.3969/j.issn.1003-0034.2010.02.010 |
| 基金项目: |
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中文摘要:
目的：报告胫骨高位嵌插截骨治疗高龄屈曲型膝内侧间隙骨关节炎的方法疗效，并与传统高位胫骨截骨的疗效进行比较。
方法：2003年7月至2007年7月对年龄60～82岁，病史3～20年，屈曲度7°～19°的膝内侧间隙骨关节炎的30例患者随机分成2组，分别进行胫骨高位嵌插截骨和传统高位截骨手术治疗。术后观察骨折愈合时间、膝关节内翻畸形和屈曲畸形恢复、膝关节功能恢复等情况。要求患者术后第4、6、8、9、10、12、14、16周及5、7、9、12个月复查，记录骨折愈合时间及内翻、屈曲角度纠正情况。术后12个月时根据Lysholm膝关节评分标准进行评分，并对2组的疗效进行比较。
结果：胫骨高位嵌插截骨组平均骨折愈合时间(9.26±2.23)周，传统高位截骨组平均(11.53±3.15)周，2组相比差异有统计学意义(P<0.05).膝关节功能恢复方面，术后1年，根据Lysholm评分标准进行评分，胫骨高位嵌插截骨平均(88.5±4.4)分，优14例，良1例；传统高位截骨组平均(78.1±5.7)分，优8例，良5例，可2例。胫骨高位嵌插截骨组术后膝关节伸直位角度0°～-1.1°，术后平均矫正(13±3.3)°；传统高位截骨组术后膝关节伸直位角度与术前相同，为(14°±3.3)°。两组术后站立位X线测量，FTA平均170.2°(l69.1°～172.3°),平均矫正12.3°～12.5°。
结论：胫骨高位嵌插截骨手术治疗膝关节内侧间隙骨关节炎缩短了骨折愈合时间，同时矫正了膝关节内翻畸形和屈曲畸形，更好地恢复了膝关节的功能，此手术方式明显优于传统的高位截骨术。 |
| 【关键词】骨关节炎，膝 胫骨 截骨术 临床对照试验 |
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| Comparative study on impacted high tibial osteotomy and conventional high tibial osteotomy for the treatment of flexional medial knee osteoarthritis in aged patients |
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ABSTRACT
Objective: To compare the therapeutic effect of impacted high tibial osteotomy and conventional high tibial osteotomy for the treatment of flexional medial osteoarthritis of knee joint in aged patients.
Methods: From July 2003 to July 2006,30 patients with flexional medial knee osteoarthritis were treated with impacted high tibial osteotomy or conventional high tibial osteotomy randomly. All patients,aged from 60 to 82 years,were suffered from 7°to 19 knee flexion deformities and 3 to 20 years medical histories. The bone healing periods,the recover of flexion and inversion deformities,and the recover of the knee joint function were observed postoperatively. The patients were followed up at 4,6,8,9,10,12 and 16 weeks,and 5,7,9 and 12 months postoperatively. The bone healing periods and the recover of flexional and inversion deformities were evaluated and compared. Twelve months postoperatively,the knee joint function were assessed with the Lysholm scoring criteria,and the therapeutic effects were compared between the two groups.
Results: There was a significant difference in the average bone healing period between the impacted high tibial osteotomy group(9.26±2.23) weeks and the conventional high tibial osteotomy group (11.53±3.15) weeks. The knee joint function were evaluated according to the Lysholm clinical rating scales. One year postoperatively,the average Lysholm score were(88.5±4.4) points in the impacted high tibial osteotomy group,and the results showed excellent in 14 cases,good in 1. The average Lysholm score were(78.1±5.7) points in the conventional high tibial osteotomy group. The results showed 8 cases excellent,5 good,2 fair,accordingly. Postoperatively,the flexion deformities of the knee in the impacted high tibial osteotomy group were -1.1° to 0° and was corrected averagely (13°±3.3°) after surgery,and that in conventional high tibial osteotomy group (14°±3.3°) (the same as preoperation). The average postoperative femorotibial angle(FTA) were 170.2°(ranged from l69.1° to 172.3°) and was corrected 12.3° to 12.5° after surgery in both groups.
Conclusion: Compared with conventional high tibial osteotomy,impacted high tibial osteotomy can significantly shorten the bone healing period,improve the knee flexion,varus deformity,and the knee function. |
| KEY WORDS Osteoarthritis,knee Tibia Osteotomy Controlled clinical trials |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 韩明涛,王飞,孙晋客,谭振华.胫骨高位嵌插截骨与传统高位截骨治疗高龄屈曲型膝内侧间隙骨关节炎的对比研究[J].中国骨伤,2010,23(2):107~110 |
| 英文格式: | HAN Ming-tao,WANG Fei,SUN Jin-ke,TANG Zhen-hua.Comparative study on impacted high tibial osteotomy and conventional high tibial osteotomy for the treatment of flexional medial knee osteoarthritis in aged patients[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(2):107~110 |
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