首页|胫骨高位截骨联合内侧半月板中央化治疗膝骨关节炎

胫骨高位截骨联合内侧半月板中央化治疗膝骨关节炎

扫码查看
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。
Analysis of the efficacy of high tibial osteotomy combined with medial meniscus centralization in knee osteoarthritis
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.

High tibial osteotomyMeniscus extrusionMeniscus centralizationKnee osteoarthritisKnee preservation

朱黎明、管捷、陈亿民、马海涛、叶家宽

展开 >

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

胫骨高位截骨 半月板外突 半月板中央化 膝骨关节炎 保膝

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
年,卷(期):2024.37(2)
  • 20