腓骨上段截骨联合关节镜清理术治疗膝关节内侧间室骨性关节炎的效果观察
Clinical study of upper fibular osteotomy combined with arthroscopic debridement in the treatment of medial compartment osteoarthritis of knee joint
王晓成 1贾博 1王昱 1吴云健 1王强1
作者信息
- 1. 浙江中医药大学附属金华中医院创伤一科,浙江金华 321017
- 折叠
摘要
目的 运用膝关节不均匀沉降理论为膝关节骨性关节炎(KOA)外科治疗提供新思路,本研究旨在探讨与单纯关节镜清理术相比,腓骨上段截骨术联合关节镜清理术治疗膝关节内侧间室骨性关节炎是否具备临床优势.方法 收集2021年1月-2023年6月于金华市中医医院完成治疗且术后随访≥6个月的125例膝关节内侧间室骨性关节炎患者相关资料,依据治疗方式不同分为对照组(单纯关节镜清理术,72例)和研究组(腓骨上段截骨联合关节镜清理术,53例),比较2组股骨胫骨角(FTA)、胫骨关节间隙角、膝关节活动度(ROM)、美国特种外科医院(HSS)评分和膝关节滑液白介素-6(IL-6)、白介素-1β(IL-1β)变化,并统计手术相关并发症发生率.结果 术后 6个月,研究组 FTA[(180.21±1.90)° vs.(182.89±1.75)°]、胫骨关节间隙角[(1.58±0.37)° vs.(3.09±0.61)°]和膝关节滑液 IL-6、IL-1β 水平均低于对照组,ROM[(91.23±7.05)° vs.(82.86±6.72)°]、HSS 评分[(74.50±7.25)分vs.(65.12±6.37)分]均高于对照组(P＜0.05),膝关节功能改善效果优于对照组(P＜0.05).2组并发症发生率差异无统计学意义(P＞0.05).结论 腓骨上段截骨术联合关节镜清理术是治疗膝关节内侧间室骨性关节炎的有效方案,能明显改善患者的下肢力量,减轻膝关节炎性损伤和提高活动功能,且安全性较好.
Abstract
Objective The theory of uneven settling of the knee joint provides a new idea for the surgical treatment of knee osteoarthritis(KOA).The objective of this study was to investigate the clinical advantages of superior fibular osteot-omy combined with arthroscopic debridement in the treatment of medial compartment osteoarthritis of the knee joint com-pared to arthroscopic debridement alone.Methods The data of 125 patients with medial compartment osteoarthritis of the knee joint who completed treatment in Jinhua Hospital of Traditional Chinese Medicine from January 2021 to June 2023 and were followed up for ≥6 months were collected.According to different treatment methods,they were divided into the control group(72 cases with arthroscopic debridement alone)and the study group(53 cases with superior fibular osteotomy combined with arthroscopic debridement).The changes of femoral tibial angle(FTA),tibial joint space an-gle,knee range of motion(ROM),hospital for special surgery(HSS)score and synovial fluid interleukin-6(IL-6)and interleukin-1β(IL-1β)were compared between the two groups,and the incidence of surgery-related complications were analyzed.Results Six months after surgery,the levels of FTA[(180.21±1.90)° vs.(182.89±1.75)°],tibial joint space angle[(1.58±0.37)° vs.(3.09±0.61)°]and IL-6 and IL-1β in synovial fluid of knee joint in the study group were lower than those in the control group.The ROM[(91.23±7.05)° vs.(82.86±6.72)°]and HSS scores[(74.50±7.25)points vs.(65.12±6.37)points]were higher than those of the control group(P＜0.05),and the im-provement of knee joint function was better than that of the control group(P＜0.05).There was no significant difference in the incidence of complications between the two groups(P＞0.05).Conclusion Upper fibular osteotomy combined with arthroscopic debridement is an effective treatment for medial compartment osteoarthritis of the knee joint,which can significantly improve the lower limb force line,reduce inflammatory injury of the knee joint and improve mobility func-tion,with good safety.
关键词
膝关节内侧间室骨性关节炎/腓骨上段截骨术/关节镜清理术/膝关节功能Key words
Medial compartment osteoarthritis of knee joint/Upper fibula osteotomy/Arthroscopic debridement/Knee joint function引用本文复制引用
出版年
2024
NETL
NSTL
万方数据