摘要
背景:膝骨关节炎是慢性骨关节疾病,其特征是半月板和软骨不同程度的损伤,关节镜技术配合胫骨高位截骨手术被认为是有效的治疗方法。目前,桥接组合式内固定系统广泛应用于骨折内固定并取得良好的疗效,但尚无其在外侧闭合胫骨高位截骨矫形中作为内固定物的临床报道。目的:探讨应用外侧闭合胫骨高位截骨桥接组合式内固定结合关节镜清理治疗内翻型膝骨关节炎的疗效、手术技巧及相关经验。方法:回顾性分析2015年1月至2016年12月应用外侧闭合胫骨高位截骨桥接组合式内固定结合关节镜清理治疗30例内翻型膝骨关节炎患者的临床资料,男14例,女16例;年龄45~70岁,平均(56.3±8.9)岁,均为单侧病变。记录手术切口长度、手术时间、骨性愈合时间和股骨胫骨角(FTA)变化情况,采用HSS评分评价膝关节功能。结果:手术切口长71~92 mm,平均(81.6±6.1)mm;手术时间50~75 min,平均(65.2±7.5)min。无血管及神经损伤、髌骨轨迹异常等并发症,下肢力线均恢复正常。30例全部获得随访,随访时间12~18个月,平均(16.5±1.4)个月。未出现骨折延迟愈合、异位骨化,未出现内固定物排异、移位及断裂。FTA由术前的185.0°±2.5°恢复至术后的172.8°±0.7°,差异具有统计学意义(P<0.05);HSS评分由术前(69.0±3.6)分提高到术后1年的(86.1±8.2)分,差异具有统计学意义(P<0.05)。结论:应用外侧闭合胫骨高位截骨桥接组合式内固定结合关节镜清理治疗膝内翻型骨关节炎的疗效可靠,创伤小、恢复快,无明显并发症,具有良好的应用前景。
Background： Knee osteoarthritis is one kind of chronic osteoarticular diseases, characterized by injury of meniscus and articular cartilage to different degrees. High tibial osteotomy combined with arthroscopy is considered as the most effective treatment for this disease. Currently, bridge combined fixation system has been widely used as internal fixation of fractures and shows remarkable effectiveness. However, no report about bridge combined fixation system used as internal fixation in high tibial osteotomy is found yet. Objective： To investigate the effectiveness, surgical skills and related experiences of lateral high tibial osteotomy combined with arthroscopic debridement and bridge combined fixation system in the treatment of knee varus osteoarthritis. Methods： Thirty patients with knee varus osteoarthritis receiving lateral high tibial osteotomy combined with arthroscopic debridement and bridge combined fixation system were retrospectively analyzed including 14 males and 16 females with the mean age as（56.3±8.9） years old（range, 45-70 years）. All patients had unilateral lesion. Length of incision, duration of operation, bone healing time and femoral tibial angle（FTA） were recorded by regular observation. Function of knee joint was evaluated with HSS knee score. Results： Length of incision was（81.6 ± 6.1） mm（range, 71-92 mm） and duration of operation was（65.2±7.5） min（range, 50-75 min）. No complication like vascular or nerve injuries or patellar tracking abnormality was observed. Force lines of lower limb were normalized in all patients. Patients were followed up for an average of（16.5±1.4） months（range, 12-18 months）. No delayed bone union, heterotopic ossification or rejection, displacement or breakage of internal fixators was observed. FTA decreased from 185.0°±2.5° pre-operatively to 172.8°±0.7° post-operatively（P〈0.05）. HSS knee score increased from 69.0±3.6 before operation to 86.1±8.2 at 1 year after operation（P〈0.05）. Conclusions�
作者
张海峰
王树平
梁鹏
孟娥
陆继广
李会全
ZHANG Haifeng;WANG Shuping;LIANG Peng;MENG E;LU Jiguang;LI Huiquan(Department of Orthopedics,Weifang Municipal Official Hospital,Weifang 261061,Shandong,China)
出处
《中华骨与关节外科杂志》
2018年第8期609-613,共5页
Chinese Journal of Bone and Joint Surgery
