股骨髁间窝成形术防止胫骨高位截骨术后髁间窝撞击的临床研究
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作者Author单位AddressE-Mail
马晟 MA Sheng 北京中医药大学第三附属医院微创外科, 北京 100029 Department of Minimally Invasive Surgery, the Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China  
田向东 TIAN Xiang-dong 北京中医药大学第三附属医院微创外科, 北京 100029 Department of Minimally Invasive Surgery, the Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China C083@bucm.edu.cn 
谭冶彤 TAN Ye-tong 北京中医药大学第三附属医院微创外科, 北京 100029 Department of Minimally Invasive Surgery, the Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China  
王剑 WANG Jian 北京中医药大学第三附属医院微创外科, 北京 100029 Department of Minimally Invasive Surgery, the Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China  
朱光宇 ZHU Guang-yu 北京中医药大学第三附属医院微创外科, 北京 100029 Department of Minimally Invasive Surgery, the Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China  
王荣田 WANG Rong-tian 北京中医药大学第三附属医院微创外科, 北京 100029 Department of Minimally Invasive Surgery, the Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China  
薛志鹏 XUE Zhi-peng 北京中医药大学第三附属医院微创外科, 北京 100029 Department of Minimally Invasive Surgery, the Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China  
胡元一 HU Yuan-yi 北京中医药大学第三附属医院微创外科, 北京 100029 Department of Minimally Invasive Surgery, the Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China  
丁天送 DING Tian-song 北京中医药大学研究生院, 北京 100029 Graduate School of Beijing University of Chinese Medicine, Beijing 100029, China  
李晓敏 LI Xiao-min 北京中医药大学研究生院, 北京 100029 Graduate School of Beijing University of Chinese Medicine, Beijing 100029, China  
期刊信息:《中国骨伤》2023年,第36卷,第10期,第943-948页
DOI:10.12200/j.issn.1003-0034.2023.10.007
基金项目:北京中医药大学重点攻关项目(编号:2020-JYB-ZDGG-142-5)
中文摘要:

目的:观察髁间窝成形术预防胫骨高位截骨术后髁间窝撞击的临床疗效。

方法:自2018年8月至2020年8月,采用关节镜联合胫骨高位截骨手术治疗84例内翻型膝骨关节炎患者,按照手术方法不同分为两组,每组42例。髁间窝成形术组男13例,女29例,年龄52~67(58.27±4.32)岁,先在关节镜下行髁间窝成形术,再行胫骨高位截骨术。镜下清理术组男16例,女26例,年龄50~71(59.02±5.14)岁,单纯行关节镜下清理术,再行胫骨高位截骨术。术后采用疼痛视觉模拟评分(visual analogue scale,VAS)、膝关节特种外科医院(hospital of special surgery,HSS)评分以及发生髁间窝撞击的情况对临床疗效进行评估。

结果:84例患者均获得随访,时间12~18(14.1±1.6)个月。术后6、12、18个月膝关节VAS与HSS评分均较术前明显改善(P<0.05),术后18个月两组患者髁间窝指数、髁间窝撞击发生率比较,差异有统计学意义(P<0.05)。

结论:髁间窝成形术可有效预防胫骨高位截骨术后髁间窝撞击的发生率,对患者术后膝关节疼痛及功能改善效果更为显著。
【关键词】髁间窝撞击  髁间窝成形术  胫骨高位截骨术  膝骨关节炎
 
Clinical study of intercondylar fossa formation to prevent intercondylar fossa impingement after high tibia osteotomy
ABSTRACT  

Objective To observe the clinical efficacy of intercondylar fossa plasty in preventing intercondylar fossa impingement syndrome after high tibial osteotomy.

Methods From August 2018 to August 2020,84 patients with inverted knee osteoarthritis were treated by arthroscopy combined with high tibial osteotomy,and were divided into two groups with 42 cases in each group according to different surgical methods. In the intercondylar fossa plasty group,there were 13 males and 29 females,age ranged from 52 to 67 years old with an average of(58.27±4.32) years old,and arthroscopic intercondylar fossa plasty was performed first,and then high tibial osteotomy. In the arthroscopic cleansing group,16 males and 26 females,age ranged from 50 to 71 years old with an average of (59.02±5.14) years old,underwent arthroscopic cleansing and then high tibial osteotomy. Postoperative treatment was evaluated using visual analogue scale(VAS),hospital for special surgery (HSS) score for the knee,and the occurrence of intercondylar percussa impingement.

Results All 84 patients were followed up,the duration ranged from 12 to 18 months with an average of (14.1±1.6) months. The VAS and HSS score of knee joint at 6,12 and 18 months after surgery were significantly improved compared with preoperative period,and there was no significant difference between the two groups (P>0.05),but the incidence of intercondylar fossa index and intercondylar fossa impact between the two groups was significantly compared 18 months after surgery (P<0.05).

Conclusion Intercondylar fossa plasty can effectively prevent the incidence of intercondylar fossa impact after high tibial osteotomy,and has a more significant effect on postoperative knee pain and function improvement.
KEY WORDS  Intercondylar fossa impingement syndrome  Intercondylar fossa plasty  High tibia osteotomy  Knee osteoarthritis
 
引用本文,请按以下格式著录参考文献:
中文格式:马晟,田向东,谭冶彤,王剑,朱光宇,王荣田,薛志鹏,胡元一,丁天送,李晓敏.股骨髁间窝成形术防止胫骨高位截骨术后髁间窝撞击的临床研究[J].中国骨伤,2023,36(10):943~948
英文格式:MA Sheng,TIAN Xiang-dong,TAN Ye-tong,WANG Jian,ZHU Guang-yu,WANG Rong-tian,XUE Zhi-peng,HU Yuan-yi,DING Tian-song,LI Xiao-min.Clinical study of intercondylar fossa formation to prevent intercondylar fossa impingement after high tibia osteotomy[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(10):943~948
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