| 胫骨高位闭合截骨联合关节镜手术治疗膝关节内侧骨关节炎5年以上随访 |
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Received:May 14, 2013
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| 作者 | Author | 单位 | Unit | E-Mail |
| 刘劲松 |
LIU Jin-song |
中国中医科学院望京医院关节四科, 北京 100102 |
Department of Arthroscopy and Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China |
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| 李智尧 |
LI Zhi-yao |
中国中医科学院望京医院关节四科, 北京 100102 |
Department of Arthroscopy and Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China |
li-zhi-yao@163.com |
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| 期刊信息：《中国骨伤》2013年26卷，第9期，第748-752页 |
| DOI：10.3969/j.issn.1003-0034.2013.09.011 |
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目的：探讨联合应用胫骨高位闭合外翻截骨和关节镜手术治疗膝内翻及内侧间室骨关节炎的价值.
方法：自2005年10月至2007年6月,对25例符合纳入标准的内侧膝关节骨关节炎的患者,通过关节镜手术和胫骨高位闭合外翻截骨进行治疗.男11例,女14例,平均年龄53岁.术前HSS功能评分平均67.6±2.8,股骨胫骨角平均(185.54±1.11)°,胫骨近端外侧解剖角平均(96.54±0.52)°.术后采用HSS膝关节功能评分标准进行评分,并通过测量股骨胫骨角及胫骨近端外侧解剖角评估矫形效果.
结果：手术均成功,没有严重并发症.所有患者获随访,时间为5～7年.术后1年HSS功能评分85.5±3.7,较术前提高(t=-33.135,P=0.000);末次随访HSS功能评分80.3±5.4,较术后1年降低(t=-13.215,P=0.000).术后1年股骨胫骨角平均(173.65±0.92)°,较术前降低(t=28.739,P=0.000);末次随访股骨胫骨角平均(174.34±0.53)°,较术后1年提高(t=2.331,P=0.048).术后1年胫骨近端外侧解剖角平均(87.32±0.33)°,较术前降低(t=37.264,P=0.000);末次随访平均(87.67±2.82)°,较术后1年提高(t=2.469,P=0.039).
结论：严格掌握适应证是保证疗效的前提,精确的手术技术是保证疗效的关键.术前计划和术中的力线观察对于保证手术成功至关重要.联合使用关节镜技术可同时处理关节内病变,关节内病变的清理和下肢力线的改善共同保证术后良好的疗效.术后骨关节炎的进展仍然在继续,但非常缓慢,中期疗效仍较满意.胫骨高位闭合外翻截骨是治疗单纯内侧膝关节骨关节炎的理想方法. |
| [关键词]:骨关节炎,膝 截骨术 膝关节 关节镜 |
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| Combined closing-wedge high tibial osteotomy with arthroscopy for varus knee and medial compartment osteoarthritis：clinical results at a minimum follow-up for five years |
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Abstract:
Objective：To study the results of closing-wedge high tibial osteotomy and arthroscopy for the treatment of medial compartment osteoarthritis of the knee.
Methods：From October 2005 to June 2007,25 pati entsmet with our inclusion criteria.All the patients with medial compartment knee osteoarthritis were treated with arthroscopy and closing-wedge high tibial osteotomy.There were 11 males and 14 females,with a mean age of 53 years old.The pre-operative HSS knee score was 67.6±2.8,FTA was (185.54±1.11)°,and aLPTA was(96.54±0.52)° in average.The patients were followed up and evaluated according to HSS knee score.The efficacy of the osteotomy was evaluated by FTA and aLPTA.
Results：All surgeries were successful without serious complication.All the patients were followed up,and the duration ranged from 5 to 7 years.The HSS was 85.5±3.7 at the 1st year and 80.3±5.4 at the latest follow-up.There was significant difference between every two scores of before operation and the two after operation(t=-33.135,P=0.000;t=-13.215,P=0.000).The FTA was(173.65±0.92)° at the 1st year and(174.34±0.53)° at the latest follow-up.There was significant difference between every two angles of before operation and after operation(t=28.739,P=0.000;t=2.331,P=0.048).The aLPTA was (87.32±0.33)° at the 1st year and (87.67±2.82)° at the latest follow-up.There was significant difference between every two angles of before operation and after operation(t=37.264,P=0.000;t=2.469,P=0.039).
Conclusion：Indication is important and good surgical technique is critical for good clinical outcome.A detailed plan before operation is essential for the operation.Arthroscopy is helpful for treating the intra-articular pathology.The osteoarthritis is still in progress but in a slow mode.The combined method of arthroscopy and closing-wedge high tibial osteotomy is a reliable way for medial compartment osteoarthritis of the knee. |
| KEYWORDS:Osteoarthritis,knee Osteotomy Knee joint Arthroscopes |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 刘劲松,李智尧.胫骨高位闭合截骨联合关节镜手术治疗膝关节内侧骨关节炎5年以上随访[J].中国骨伤,2013,26(9):748~752 |
| 英文格式: | LIU Jin-song,LI Zhi-yao.Combined closing-wedge high tibial osteotomy with arthroscopy for varus knee and medial compartment osteoarthritis：clinical results at a minimum follow-up for five years[J].zhongguo gu shang / China J Orthop Trauma ,2013,26(9):748~752 |
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