| 胫骨高位截骨术后二次镜下探查软骨修复情况 |
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投稿时间：2020-01-07
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| 作者 | Author | 单位 | Address | E-Mail |
| 韩昶晓 |
HAN Chang-xiao |
北京中医药大学, 北京 100029 |
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| 田向东 |
TIAN Xiang-dong |
北京中医药大学第三附属医院微创关节科, 北京 100029 |
Department of Minimally InvasiveJoint, the Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China |
tianxd7802@sina.com |
| 王剑 |
WANG Jian |
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| 谭冶彤 |
TAN Ye-tong |
北京中医药大学第三附属医院微创关节科, 北京 100029 |
Department of Minimally InvasiveJoint, the Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China |
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| 朱光宇 |
ZHU Guang-yu |
北京中医药大学第三附属医院微创关节科, 北京 100029 |
Department of Minimally InvasiveJoint, the Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China |
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| 雷鸣 |
LEI Ming |
北京中医药大学第三附属医院微创关节科, 北京 100029 |
Department of Minimally InvasiveJoint, the Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China |
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| 马晟 |
MA Sheng |
北京中医药大学第三附属医院微创关节科, 北京 100029 |
Department of Minimally InvasiveJoint, the Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China |
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| 胡元一 |
HU Yuan-yi |
北京中医药大学第三附属医院微创关节科, 北京 100029 |
Department of Minimally InvasiveJoint, the Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China |
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| 李述文 |
LI Shu-wen |
北京中医药大学, 北京 100029 |
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| 陈汉东 |
CHEN Han-dong |
北京中医药大学, 北京 100029 |
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| 黄叶 |
and HUANG Ye |
北京中医药大学, 北京 100029 |
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| 期刊信息：《中国骨伤》2020年，第33卷，第5期，第465-469页 |
| DOI：10.12200/j.issn.1003-0034.2020.05.015 |
| 基金项目:北京中医药大学基本科研业务青年教师项目（编号：2019-JYB-JS-178） |
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中文摘要:
目的：评估胫骨高位截骨术后膝关节内软骨修复情况。
方法：选取2017年9月至2019年9月行胫骨高位截骨术，并在取内固定时再次镜下探查患者11例；其中男2例，女9例，年龄55~64岁。手术前后取内固定时留取内外间室图片并采用国际软骨修复协会软骨损伤分级系统（International Cartilage Repair Society grading systerm，ICRS）评估内外侧股骨髁与胫骨平台软骨损伤程度，采用美国西安大略与麦克马斯特大学骨关节炎指数评分（the Westrn Ontarioand Mcmaster Universities osteoarthritis index，WOMAC）与下肢力线比率（weight bearing line，WBL）评估临床效果与力线矫正情况。
结果：11例患者均获得随访，时间12~22个月；所有患者的内侧股骨髁与胫骨平台损伤软骨得到不同程度的修复，WOMAC评分总分由术前的102~127分改善至41~52分，下肢力线比率由术前的17%~34%矫正至58%~64%；所有切口Ⅰ期愈合，术中及术后无内固定断裂、感染等并发症发生。
结论：经胫骨高位截骨术矫正下肢力线，可以改善膝关节疼痛与功能障碍，并且损伤的内侧间室软骨可被不同程度修复。 |
| 【关键词】软骨修复 胫骨高位截骨术 关节镜检查 膝骨关节炎 |
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| Evaluation of cartilage regeneration by arthroscopy after high tibial osteotomy |
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ABSTRACT
Objective: To evaluate the cartilage regeneration in the knee joint by arthroscopy after high tibial osteotomy.
Methods: Eleven patients were included in the study who were treated with high tibial osteotomy and underwent microscopy when the internal fixation was unloaded from September 2017 to September 2019. Among them,there were 2 males and 9 females,aged from 55 to 64 years old. The internal and external compartment pictures of the knee were taken before and after surgery of removing the internal fixation and the International Cartilage Repair Society(ICRS) grading systerm was used to evaluate the degree of cartilage damage on the medial and lateral femoral condyles and tibial plateau. The Westrn Ontarioand Mcmaster Universities osteoarthritis index (WOMAC) and the weight bearing line (WBL) were used to evaluate the function of the knee and the alignment of the lower limb.
Results: All 8 patients were followed up for more than 12 months,ranging from 12 to 22 months. The degenerated cartilage of the medial femoral condyle and medial tibial plateau was covered by newly regenerated cartilage. WOMAC score decreased from 102-127 to 41-52 and WBL was improved from 17%-34% to 58%-64%. All incisions healed in stageⅠ,and no complications such as internal fixation rupture and infection occurred during and after the operation.
Conclusion: High tibial osteotomy can relieve the pain of the knee and the dysfunction by adjusting lower limb alignment,and the degenerated cartilage could be regenerated in the medial femoral condyle and medial tibial plateau. |
| KEY WORDS Cartilage regeneration High tibial osteotomy Arthroscopy Knee osteoarthritis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 韩昶晓,田向东,王剑,谭冶彤,朱光宇,雷鸣,马晟,胡元一,李述文,陈汉东,黄叶.胫骨高位截骨术后二次镜下探查软骨修复情况[J].中国骨伤,2020,33(5):465~469 |
| 英文格式: | HAN Chang-xiao,TIAN Xiang-dong,WANG Jian,TAN Ye-tong,ZHU Guang-yu,LEI Ming,MA Sheng,HU Yuan-yi,LI Shu-wen,CHEN Han-dong,and HUANG Ye.Evaluation of cartilage regeneration by arthroscopy after high tibial osteotomy[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(5):465~469 |
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