| 单平面胫骨高位截骨术治疗内翻型膝骨关节炎合并内侧半月板后根损伤的临床疗效 |
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投稿时间：2024-03-21
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| 作者 | Author | 单位 | Address | E-Mail |
| 王春久 |
WANG Chun-jiu |
北京中医药大学第三附属医院微创关节科, 北京 100029 |
Department of Minimally Invasive Surgery, the Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China |
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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 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关节科, 北京 100029 |
Department of Minimally Invasive Surgery, the Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China |
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| 薛志鹏 |
XUE Zhi-peng |
北京中医药大学第三附属医院微创关节科, 北京 100029 |
Department of Minimally Invasive Surgery, the Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China |
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| 张伟 |
ZHANG Wei |
北京中医药大学第三附属医院微创关节科, 北京 100029 |
Department of Minimally Invasive Surgery, the Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China |
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| 李晓敏 |
LI Xiao-min |
北京中医药大学, 北京 100029 |
Graduate School of Beijing University of Chinese Medicine, Beijing 100029, China |
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| 刘昂 |
LIU Ang |
北京中医药大学, 北京 100029 |
Graduate School of Beijing University of Chinese Medicine, Beijing 100029, China |
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| 期刊信息：《中国骨伤》2024年，第37卷，第9期，第886-892页 |
| DOI：10.12200/j.issn.1003-0034.20230948 |
| 基金项目:北京中医药大学重点攻关项目(编号:2020-JYB-ZDGG-142-5) |
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中文摘要:
目的: 探讨胫骨结节远端单平面截骨术 (distal tibial tubercle-high tibial osteotomy,DTT-HTO)治疗内翻型膝骨关节炎(knee osteoarthritis,KOA)伴内侧半月板后根损伤(medial meniscus posterior root tear,MMPRT)的临床疗效。
方法: 回顾性分析2020年5月至2021年12月收治的21例接受DTT-HTO治疗的内翻型KOA伴MMPRT患者,男3例,女18例;年龄49~75(63.81±6.56)岁;病程0.5~18.0(5.9±4.2)年;Kellgren-Lawrence(K-L)分级为Ⅱ级4例,Ⅲ级14例,Ⅳ级3例。MMPRT损伤分型为1型14例,2型7例。比较术前与术后12个月内侧半月板突出(medial meniscusextrusion,MME)距离、下肢力线比率(weight-bearing line ratio,WBLR);分别于术前,术后1、6及12个月采用疼痛视觉模拟评分(visual analogue scale,VAS)、Western Ontario and McMaster大学骨关节炎指数(Western Ontario and McMaster Universities Osteiarthritis Index,WOMAC)、Lysholm膝关节评分评估膝关节疼痛和功能改善情况。
结果: 21例患者完成随访,时间12~18(13.52±1.72)个月。MME距离由术前的(4.99±1.05) mm改善至术后12个月的(1.87±0.76) mm (P＜0.05)。WBLR由术前的(15.49±7.04)%增加至术后12个月的(62.71±2.27)% (P＜0.05);VAS由术前的(7.00±1.14)分降至术后1、6、12个月的(2.04±0.80)、(0.90±0.62)、(0.61±0.50)分(P＜0.05);WOMAC由术前的(147.90±9.88)分降低至术后1、6、12个月的(103.43±8.52)、(74.00±9.54)、(47.62±9.53)分,差异有统计学意义(P＜0.05);Lysholm评分由术前的(46.04±7.34)分增加至术后1、6、12个月的(63.19±8.93)、(81.10±6.41)、(89.29±3.04)分(P＜0.05)。
结论: DTT-HTO治疗内翻型KOA伴MMPRT,能够减少内侧半月板突出距离,改善下肢力线比率,有效减轻膝关节疼痛和改善膝关节功能。 |
| 【关键词】截骨术 膝骨关节炎 内侧半月板后根损伤 内侧半月板突出 |
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| High tibial osteotomy on varus knee osteoarthritis with medial meniscus posterior root injury |
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ABSTRACT
Objective To explore clinical effect of distal tibial tubercle-high tibial osteotomy (DTT-HTO) in treating knee osteoarthritis (KOA) with medial meniscus posterior root tear (MMPRT).
Methods A retrospective analysis was performed on 21 patients with varus KOA with MMPRT from May 2020 to December 2021,including 3 males and 18 females,aged from 49 to 75 years old with an average of (63.81±6.56) years old,the courses of disease ranged from 0.5 to 18.0 years with an average of(5.9±4.2) years,and 4 patients with grade Ⅱ,14 patients with grade Ⅲ,and 3 patients with grade Ⅳ according to Kellgren-Lawrence;14 patients with type 1 and 7 patients with type 2 according to MMPRT damage classification. The distance of medial meniscusextrusion (MME) and weight-bearing line ratio (WBLR) of lower extremity were compared before and 12 months after operation. Visual analogue scale (VAS),Western Ontarioand and McMaster Universities (WOMAC) osteoarthritis index,and Lysholm knee score were used to evaluate knee pain and functional improvement before operation,1,6 and 12 months after operation,respectively.
Results Twenty-one patients were followed up for 12 to 18 months with an average of (13.52±1.72) months. MME distance was improved from (4.99±1.05) mm before operation to (1.87±0.76) mm at 12 months after operation (P＜0.05). WBLR was increased from (15.49±7.04)% before operation to (62.71±2.27)% at 12 months after operation (P＜0.05). VAS was decreased from (7.00±1.14) before operation to (2.04±0.80),(0.90±0.62) and (0.61±0.50) at 1,6 and 12 months after operation. WOMAC were decreased from preoperative (147.90±9.88) to postoperative (103.43±8.52),(74.00±9.54) and (47.62±9.53) at 1,6 and 12 months,and the difference were statistically significant (P＜0.05). Lysholm scores were increased from (46.04±7.34) before oepration to (63.19±8.93),(81.10±6.41) and (89.29±3.04) at 1,6 and 12 months after operation(P＜0.05).
Conclusion For the treatment of varus KOA with MMPRT,DTT-HTO could reduce medial meniscus protrusion distance,improve the ratio of lower limb force line,and effectively reduce knee pain and improve knee joint function. |
| KEY WORDS Osteotomy Knee osteoarthritis Medial meniscus posterior root tear Medial meniscusextrusion |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王春久,田向东,谭冶彤,薛志鹏,张伟,李晓敏,刘昂.单平面胫骨高位截骨术治疗内翻型膝骨关节炎合并内侧半月板后根损伤的临床疗效[J].中国骨伤,2024,37(9):886~892 |
| 英文格式: | WANG Chun-jiu,TIAN Xiang-dong,TAN Ye-tong,XUE Zhi-peng,ZHANG Wei,LI Xiao-min,LIU Ang.High tibial osteotomy on varus knee osteoarthritis with medial meniscus posterior root injury[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(9):886~892 |
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