膝关节骨性关节炎腓骨截骨前后软骨代谢产物变化的研究
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作者Author单位AddressE-Mail
程碧 CHENG Bi 梧州红十字会医院骨科, 广西 梧州 543002 Department of Orthopaedics, Wuzhou Red Cross Hospital, Wuzhou 543002, Guangxi, China vince.nba@163.com 
何锦威 HE Jin-wei 梧州红十字会医院骨科, 广西 梧州 543002 Department of Orthopaedics, Wuzhou Red Cross Hospital, Wuzhou 543002, Guangxi, China  
江梦谣 JIANG Meng-yao 梧州红十字会医院骨科, 广西 梧州 543002 Department of Orthopaedics, Wuzhou Red Cross Hospital, Wuzhou 543002, Guangxi, China  
期刊信息:《中国骨伤》2022年,第35卷,第9期,第843-847页
DOI:10.12200/j.issn.1003-0034.2022.09.008
基金项目:广西壮族自治区卫生健康委员会自筹经费科研课题(编号:Z20200823)
中文摘要:

目的:探讨膝关节骨性关节炎患者腓骨截骨前后软骨代谢中的Ⅱ型胶原3/4片段C末端裂解表位(C-terminal cleavage epitope of typeⅡcollagen 3/4 fragment,Col2-3/4Clong mono or C2C),Ⅱ型胶原羧基端端肽(carboxyl-terminal telopeptide of typeⅡcollagen,CTX-Ⅱ)及膝关节功能变化。

方法:自2019年1月至2020年3月采用腓骨截骨术治疗65例内侧疼痛的膝关节骨性关节炎患者,其中男25例,女40例;年龄44~70(56.20±10.05)岁;Kellgren-Lawrence分级,Ⅰ级25例,Ⅱ级19例,Ⅲ级17例,Ⅳ级4例。分别于截骨前、截骨后6个月检测膝关节液的CTX-Ⅱ、C2C水平以及血清白细胞介素-1β(interleukin-1β,IL-1β),肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平。采用疼痛视觉模拟评分(visual analogue scale,VAS)评估患者疼痛缓解情况,采用美国膝关节协会评分(Keen Society Score,KSS)和美国特种外科医院(Hospital for Special Surgery,HSS)膝关节评分评估膝关节功能恢复情况。

结果:65例均获得随访,时间6~18(12.4±3.6)个月。截骨后6个月,VAS、KSS、HSS评分优于截骨前(P<0.05)。截骨后6个月血清IL-1β、TNF-α、膝关节液CTX-Ⅱ和C2C均低于截骨前(P<0.05)。

结论:腓骨截骨可缓解膝关节骨性关节炎患者疼痛,维持关节受力平衡,减轻患者机体炎症反应,改善软骨代谢状态,减少关节软骨的分解,使CTX-Ⅱ、C2C水平下调,有利于退变关节软骨的再生,促进膝关节功能恢复。
【关键词】骨关节炎,膝  截骨术  软骨  白细胞介素-1β
 
Study on the changes of cartilage metabolites in patients with knee osteoarthritis before and after fibula osteotomy
ABSTRACT  

Objective: To explore changes of C-terminal cleavage epitope of type Ⅱ collagen 3/4 fragment in cartilage metabolism (Col2-3/4Clong mono or C2C),carboxyl-terminal telopeptide of type Ⅱ collagen (CTX-Ⅱ) and knee joint function before and after osteotomy of fibula in patients with knee osteoarthritis.

Methods: From January 2019 to March 2020,65 patients with knee osteoarthritis who underwent fibular osteotomy treatment accompanied with medial pain were selected,including 25 males and 40 females,aged from 44 to 70 years old with an average of (56.20±10.05) years old;25 patients were gradeⅠ,19 patients with gradeⅡ,17 patients with grade Ⅲ,and 4 patients with grade Ⅳ according to Kellgren-Lawrence grading.The content of CTX-Ⅱ and C2C in knee joint fluid,serum interleukin 1β(IL-1β),tumor necrosis factor-α(TNF-α) before osteotomy and 6 months after osteotomy were detected.Visual analogue scale (VAS) was used to evaluate degree of pain relief,American Knee Society Score (KSS) and Hospital for Special Surgery (HSS) were applied to evaluate recovery of knee joint function.

Results: Sixty-five patients were followed up from 6 to 18 months with an average of (12.4±3.6) months.VAS,KSS and HSS score at 6 months after osteotomy were better than that of before osteotomy (P<0.05).Serum IL-1β,TNF-α and content of CTX-Ⅱand C2C of knee joint fluid at 6 months after osteotomy were lower than those before osteotomy (P<0.05).

Conclusion: Fibula osteotomy could relieve pain of knee osteoarthritis,maintain balance of joint stress,reduce organism inflammatory response,improve cartilage metabolism,reduce decomposition of articular cartilage,and reduce level of CTX-Ⅱand C2C,which is benefit for regeneration of articular cartilage and promote recovery of knee joint function.
KEY WORDS  Osteoarthritis,knee  Ostrotomy  Cartilage  Interleukin-1β
 
引用本文,请按以下格式著录参考文献:
中文格式:程碧,何锦威,江梦谣.膝关节骨性关节炎腓骨截骨前后软骨代谢产物变化的研究[J].中国骨伤,2022,35(9):843~847
英文格式:CHENG Bi,HE Jin-wei,JIANG Meng-yao.Study on the changes of cartilage metabolites in patients with knee osteoarthritis before and after fibula osteotomy[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(9):843~847
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