| 胫骨高位截骨联合内侧半月板中央化治疗膝骨关节炎 |
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投稿时间：2022-12-19
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| 作者 | Author | 单位 | Address | E-Mail |
| 朱黎明 |
ZHU Li-ming |
杭州市萧山区第一人民医院骨科运动医学中心, 浙江 杭州 311201 |
Sports Medicine Center, Department of Orthopedics, the First People's Hospital of Xiaoshan District, Hangzhou 311201, Zhejiang, China |
hzzhuliming@163.com |
| 管捷 |
GUAN Jie |
杭州市萧山区第一人民医院骨科运动医学中心, 浙江 杭州 311201 |
Sports Medicine Center, Department of Orthopedics, the First People's Hospital of Xiaoshan District, Hangzhou 311201, Zhejiang, China |
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| 陈亿民 |
CHEN Yi-min |
杭州市萧山区第一人民医院骨科运动医学中心, 浙江 杭州 311201 |
Sports Medicine Center, Department of Orthopedics, the First People's Hospital of Xiaoshan District, Hangzhou 311201, Zhejiang, China |
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| 马海涛 |
MA Hai-tao |
杭州市萧山区第一人民医院骨科运动医学中心, 浙江 杭州 311201 |
Sports Medicine Center, Department of Orthopedics, the First People's Hospital of Xiaoshan District, Hangzhou 311201, Zhejiang, China |
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| 叶家宽 |
YE Jia-kuan |
杭州市萧山区第一人民医院骨科运动医学中心, 浙江 杭州 311201 |
Sports Medicine Center, Department of Orthopedics, the First People's Hospital of Xiaoshan District, Hangzhou 311201, Zhejiang, China |
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| 期刊信息：《中国骨伤》2024年，第37卷，第2期，第173-178页 |
| DOI：10.12200/j.issn.1003-0034.20220491 |
| 基金项目: |
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中文摘要:
目的：探讨胫骨高位截骨（high tibial osteotomy，HTO）联合内侧半月板中央化治疗膝骨关节炎（knee osteoarthritis，KOA）的临床疗效。
方法：回顾分析2018年10月至2020年10月接受手术治疗的KOA患者26例，其中行胫骨高位截骨联合关节镜下半月板中央化手术14例为中央化组，男8例，女6例，年龄（50.2±1.4）岁，随访时间（16.8±4.0）个月；仅行胫骨高位截骨术12例患者为对照组，男6例，女6例，年龄（50.9±1.8）岁，随访时间（19.0±4.8）个月。记录并比较两组手术时间、术前后膝关节Lysholm评分和膝关节2000IKDC评分、MRI、股骨胫骨角（femur tibia angle，FTA）、髋膝踝角（hip knee ankle angle，HKA）等放射学影像及并发症情况。
结果：术后患者切口均获Ⅰ期愈合，无并发症。中央化组手术时间长于对照组[（65.0±2.1） min vs 52.0±2.1） min，P<0.05]。中央化组内侧半月板外突减少值明显高于对照组[（2.8±1.4） mm vs （1.1±2.2） mm，P<0.05]。两组FTA、HKA、膝关节Lyshlom评分、膝关节2000 IKDC评分比较，差异均无统计学意义（P>0.05）。两组术后膝关节Lyshlom评分、膝关节2000 IKDC评分均较术前改善（P<0.05）。
结论：胫骨高位截骨联合内侧半月板中央化可改善早期KOA内侧半月板外突，改善术后膝关节功能，中远期疗效仍需要多病例的长期随访。 |
| 【关键词】胫骨高位截骨 半月板外突 半月板中央化 膝骨关节炎 保膝 |
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| Analysis of the efficacy of high tibial osteotomy combined with medial meniscus centralization in knee osteoarthritis |
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ABSTRACT
Objective To explore the efficacy of high tibial osteotomy (HTO) combined with medial meniscus centralization in knee osteoarthritis.
Methods A total of 26 patients who underwent surgery from October 2018 to October 2020 were reviewed. Among them, 14 patients underwent high tibial osteotomy combined with arthroscopic meniscus centralization surgery were centralized group, including 8 males and 6 females, with an average age of (50.2±1.4) years old and follow-up time of (16.8±4.0) months. Twelve patients with high tibial osteotomy were in the control group, including 6 males and 6 females, with an average age of (50.9±1.8) years and follow-up time of (19.0±4.8) months. Operation time, the knee Lysholm score, knee 2000 IKDC score, MRI, femoral tibial angle(FTA), hip knee ankle angle (HKA), and intraoperative and postoperative complications were recorded.
Results All the incisions healed without any complication. The operation time in the centralized group was longer than that in the control group[(65.0±2.1)min vs(52.0±2.1)min, P<0.05]. The medial meniscus extrusion reduction value in the centralized group was significantly reduced compared with the control group[(2.8±1.4) mm vs (1.1±2.2) mm, P<0.05]. The FTA, HKA, knee Lyshlom score, and 2000 IKDC score between two groups were no significantly (P>0.05). Postoperative knee Lyshlom score and knee 2000 IKDC score improved in both groups(P<0.05).
Conclusion HTO combined with centralization of medial meniscus can improve the reduction of medial meniscus and improve knee function. The medium and long-term curative effect still needs long-term follow-up of more cases. |
| KEY WORDS High tibial osteotomy Meniscus extrusion Meniscus centralization Knee osteoarthritis Knee preservation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 朱黎明,管捷,陈亿民,马海涛,叶家宽.胫骨高位截骨联合内侧半月板中央化治疗膝骨关节炎[J].中国骨伤,2024,37(2):173~178 |
| 英文格式: | ZHU Li-ming,GUAN Jie,CHEN Yi-min,MA Hai-tao,YE Jia-kuan.Analysis of the efficacy of high tibial osteotomy combined with medial meniscus centralization in knee osteoarthritis[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(2):173~178 |
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