目的 探讨使用股骨髁上截骨术(distal femoral osteotomy，DFO)治疗膝关节外侧半月板损伤合并外翻膝骨关节炎的疗效。方法 本研究选取了 2019年1月至2023年2月华中科技大学同济医学院附属同济医院采用DFO治疗膝关节外侧半月板损伤合并外翻膝骨关节炎的15例患者。其中男2例，女13例;年龄39～63岁，平均(51。20±6。71)岁。膝关节外侧间室关节炎Kellgren-Lawrence(K-L)分级，Ⅰ级2例，Ⅱ级11例，Ⅲ级2例。记录手术时间、术中出血量、术后引流量、住院时间。分别记录所有患者术前、术后3个月、术后6个月以及末次随访的疼痛视觉模拟评分(visual analog scale，VAS)、Tegner 评分、美国特种外科医院(the hospital special surgery，HSS)评分、Lysholm 评分及Kujala评分评价临床疗效。结果 患者均随访12～18个月，平均(13。67±2。13)个月。手术时间65～115 min，术中出血量100～200 mL，住院时间5～8d。切口均一期愈合。术后6个月股骨截骨处均基本愈合。术后无股骨外侧骨皮质骨折，股骨内侧无钢板刺激症状，无深静脉血栓、血管神经损伤及感染，无截骨处延迟愈合或不愈合，无关节不稳、关节僵直等并发症发生。术后3个月、6个月及末次随访VAS评分、HSS评分、Lysholm评分及Kujala评分均明显优于术前(P＜0。001)。术后6个月及末次随访的Tegner评分明显优于术前(P＜0。001)。结论 DFO治疗外侧半月板损伤合并外翻膝骨关节炎，能有效改善下肢力线，缓解膝关节外侧疼痛，同时能获得较好的下肢力线矫正效果，截骨处愈合良好，患者可早期下床活动，短期疗效满意。
Clinical Outcomes of Distal Femoral Osteotomy for Lateral Meniscus Injury with Valgus Knee Osteoarthritis
Objective To evaluate the effectiveness of distal femoral osteotomy(DFO)in managing patients with lateral meniscus injury accompanied by varus knee osteoarthritis.Methods This study enrolled 15 patients who underwent DFO for lateral meniscus injury and varus knee osteoarthritis at Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,between January 2019 and February 2023.The cohort comprised 2 males and 13 females,aged 39～63 years,mean age(51.20±6.71)years.The severity of osteoarthritis in the lateral compartment of the knee was graded using the Kellgren-Lawrence(K-L)system:Grade Ⅰ in 2 cases,Grade Ⅱ in 11 cases,and Grade Ⅲ in 2 cases.Surgical duration,intraoperative blood loss,postoperative drainage,and hospital stay were documented.Clinical outcomes were assessed preoperatively,at 3 and 6 months postoperatively,and at the final follow-up using the pain visual analog scale(VAS),Tegner score,the hospital for special surgery(HSS)score,Lysholm score,and Kujala score.Results 15 patients were followed up for 12～18 months,with a mean of(13.67±2.13)months.Surgical duration ranged from 65 to 115 minutes,with intraoperative blood loss of 100～200 mL.Hospital stay was 5～8 days.All incisions healed primarily.By 6 months postoperatively,the femoral osteotomy site had healed.No complications such as lateral femoral cortical fractures,medial femoral plate irritation,deep vein thrombosis,vascular or nerve injuries,infections,delayed healing,non-union at the osteotomy site,joint instability,or stiffness were observed.Significant improvements in pain VAS,HSS scores,Lysholm scores,Kujala scores,and Tegner scores(at 6 months postoperatively and at the final follow-up)were noted compared to preoperative scores(P＜0.001).Conclusion DFO for lateral meniscus injury combined with varus knee osteoarthritis effectively improves lower limb alignment,alleviates lateral knee pain,and maintains good alignment correction.The osteotomy site heals well,enabling early ambulation and yielding satisfactory short-term outcomes.
万方数据
维普
