中国骨伤2024,Vol.37Issue(2) :173-178.DOI:10.12200/j.issn.1003-0034.20220491

胫骨高位截骨联合内侧半月板中央化治疗膝骨关节炎

Analysis of the efficacy of high tibial osteotomy combined with medial meniscus centralization in knee osteoarthritis

朱黎明 管捷 陈亿民 马海涛 叶家宽
中国骨伤2024,Vol.37Issue(2) :173-178.DOI:10.12200/j.issn.1003-0034.20220491

胫骨高位截骨联合内侧半月板中央化治疗膝骨关节炎

Analysis of the efficacy of high tibial osteotomy combined with medial meniscus centralization in knee osteoarthritis

朱黎明 1管捷 1陈亿民 1马海涛 1叶家宽1
扫码查看

作者信息

  • 1. 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
  • 折叠

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 os-teoarthritis,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2000IKDC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.

Abstract

Objective To explore the efficacy of high tibial osteotomy(HTO)combined with medial meniscus centraliza-tion in knee osteoarthritis.Methods A total of 26 patients who underwent surgery from October 2018 to October 2020 were re-viewed.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 compli-cations 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).Postop-erative 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.

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

Key words

High tibial osteotomy/Meniscus extrusion/Meniscus centralization/Knee osteoarthritis/Knee preservation

引用本文复制引用

出版年

2024
中国骨伤
中国中西医结合学会,中国中医研究院

中国骨伤

CSTPCD
影响因子:1.876
ISSN:1003-0034
参考文献量20
段落导航相关论文