摘要
目的评价单纯关节镜清理与关节镜清理联合腓骨近端截骨术治疗膝关节骨性关节炎(Knee osteoarthritis,KOA)的临床疗效。方法回顾性分析2019年4月-2021年1月乌鲁木齐市友谊医院骨一科收治的50例KOA患者术前及术后的临床相关资料。随机分为单纯组(24例)和联合组(26例),单纯组采用关节镜下膝关节清理术方法治理,联合组采用关节镜下膝关节清理联合腓骨近端截骨术方法治疗。治疗后分析比较术前、术后、术后1月、半年及一年2组患者间疼痛视觉模拟评分(VAS)、AKS评分及Lysholm评分变化,手术前、后抽取膝关节液检查白细胞介素-6(IL-6)、肿瘤坏死因子(TNF-a)变化情况及手术前、后有无并发症出现。结果与术前比较,两组患者术后VAS评分及关节液内IL-6和TNF-a水平降低,Lysholm和AKS评分升高,差异均有统计学意义(P<0.05)。与单纯治疗组术后比较,联合治疗组术后VAS评分及关节液内IL-6、TNF-a水平降低,Lysholm及AKS评分升高,差异有统计学意义(P<0.05)。单纯组术后内翻角及FTA角度无明显改善,差异无统计学意义(P<0.05),术后12个月内翻角度较术前有增加;联合组术后内翻角及FTA角度减小,差异均有统计学意义(P<0.05)。结论关节镜下膝关节清理联合腓骨截骨术有效的弥补了单纯关节镜清理治疗KOA的部分不足,是一种安全、有效的治疗KOA的手术方式,同时可改善下肢负重力线促进患肢功能康复。
Objective To evaluate the efficacy of arthroscopic cleanup alone versus arthroscopic cleanup combined with proximal fibular osteotomy in the treatment of osteoarthritis of the knee osteoarthritis(KOA).Methods The clinical data of 50 patients with KOA treated in the First Department of Orthopedics of Urumqi Friendship Hospital from April 2019 to January 2021 were analyzed retrospectively.They were randomly divided into simple group(24 cases)and combined group(26 cases).The simple group was treated with arthroscopic knee debridement,while the combined group was treated with arthroscopic knee debridement combined with proximal fibular osteotomy.After treatment,the changes of pain visual analogue scale(VAS),AKS score and Lysholm score between the two groups before,after,1 month,6 months and 1 year of post-operation were analyzed and compared.The knee joint fluid was taken before and after operation to check the changes of interleukin-6(IL-6),tumor necrosis factorα(TNF-α)and whether there were complications before and after operation.Results Compared with before operation,the VAS score and the levels of IL 6 and TNF-αin articular fluid decreased,and the Lysholm and AKS scores increased in the two groups(P<0.05).Compared with the simple treatment group,the VAS score and the levels of IL-6 and TNF-αof joint fluid in the combined treatment group decreased,and the Lysholm and AKS scores increased(P<0.05).There was no significant difference in varus angle and FTA angle in the simple group(P<0.05);the varus angle and FTA angle decreased in the combined group(P<0.05).Conclusion Arthroscopic knee cleanup combined with fibular osteotomy effectively compensates for some of the deficiencies of simple arthroscopic cleanup for KOA,which is a safe and effective surgical procedure for the treatment of KOA,meanwhile improving the negative gravity line of the lower limb to promote functional rehabilitation of the affected limb.
作者
梁振
宋峰
赵之颢
LIANG Zhen;SONG Feng;ZHAO Zhihao(Department of Orthopedics,Urumqi Friendship Hospital,Urumqi 830000;Department of Orthopedics,the Sixth Affili-ated Hospital of Xinjiang Medical University,Urumqi 830002,China)
出处
《新疆医科大学学报》
CAS
2021年第9期1085-1088,共4页
Journal of Xinjiang Medical University
基金
新疆维吾尔自治区卫生健康青年医学科技人才专项科研项目(WJWY-201915)。
关键词
膝关节骨性关节炎
腓骨近端截骨
关节镜下膝关节清理
炎症因子
knee osteoarthritis(KOA)
proximal fibula osteotomy
arthroscopic knee debridement
inflammatory factors
