摘要
目的：探讨关节镜联合胫骨结节抬高术治疗髌股关节骨性关节炎的临床疗效。方法：自2011年12月至2013年2月山东中药大学附属医院运动损伤骨科病房收治的69例髌股关节骨性关节炎住院患者：其中男20例,女49例;年龄48-60岁,随访期限为术后11-18个月,平均12.5个月。按手术方式分为两组即综合治疗组与单纯关节镜组,综合治疗组为关节镜下清理和外侧支持带松解联合胫骨结节抬高术,单纯关节镜组为关节镜下清理和外侧支持带松解。术后采用Lysholm评分和VAS评分进行疗效评定及髌股匹配角、髌骨倾斜角及髌骨外移度指标进行放射学评定。同一组内术前术后与两组间术后观察指标的比较采用t检验,两组性别比较用χ2检验,所有试验数据用SPSS20.0软件包做统计学处理,以P〈0.05为差异有统计学意义。结果：关节镜联合胫骨结节抬高术组术后优良率为86.1%,单纯关节镜组术后优良率为51.5%,两组优良率经t检验（P〈0.05）,两组疗效有差异且综合组的术后疗效优良率高于单纯关节镜组。关节镜联合胫骨结节抬高术方法与单纯关节镜方法在治疗髌股关节骨性关节炎,近期的临床观察都有明确的疗效,能够改善膝关节的整体功能,明显缓解膝前疼痛,关节镜联合胫骨结节抬高术方法优于单纯关节镜方法。治疗过程中未见明显并发症。结论：关节镜联合胫骨结节抬高手术方法为临床提供了一种安全有效的治疗方法,具有广泛的临床应用前景,值得进一步深入研究。
Objective：To investigate clinical efficacy of arthroscopy combined with tibial elevation for treating patellofemoral osteoarthritis.Methods：All 69 cases with patellofemoral osteoarthritis were received from our hospital from December2011 to February 2013.They were 20 men,49women,aged 48 to 60years,and followed up for 11 months to 18 months,12.5months averagely.They were divided into comprehensive treatment group,patients in which group were treated combined with arthroscopic and tibial elevation,and simple arthroscopic group,patients in which group were treated with arthroscopic only.The Lysholm score and VAS score were used to evaluate the curative effect,and the patellofemoral matching angle,patellar tilt angle,and patellar lateral shift ratio index were used for evaluate radiological effect.All test data was statistically processing with PSSS 20.0software package.Results：The excellent and good rate was 86.1%and 51.5%in the comprehensive group and simple arthroscopy group respectively（P〈0.05）.Conclusion：Arthroscopy combined with tibial elevation and arthroscopy singly are both effective for treating patellofemoral osteoarthritis in recent clinical observation,which can improve the overall function of knee joint,and can relieve anterior knee pain.In the course of treatment,there is no significant complication.Arthroscopic combined with tibial elevation provides a safe and effective treatment option for the clinical,it is worthy for wide application and for further study.
出处
《中国中医骨伤科杂志》
CAS
2016年第3期21-25,共5页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
关键词
关节镜
髌股关节骨性关节炎
外侧支持带松解
胫骨结节抬高术
arthroscopy
patellofemoral osteoarthritis
lateral retinacular release
tibial tubercle anteromedial transfer
