目的:探讨个性化截骨导板辅助胫骨高位截骨治疗膝关节骨性关节炎(Knee Osteoarthritis,KOA)的临床效果。方法:选取2020年5月至2021年5月60例KOA患者,采用随机数字表法分为对照组和导板组(各30例),对照组行内侧开放楔形胫骨高位截骨术(Op...目的:探讨个性化截骨导板辅助胫骨高位截骨治疗膝关节骨性关节炎(Knee Osteoarthritis,KOA)的临床效果。方法:选取2020年5月至2021年5月60例KOA患者,采用随机数字表法分为对照组和导板组(各30例),对照组行内侧开放楔形胫骨高位截骨术(Opening Wedge High Tibial Osteotomy,OWHTO)治疗,导板组行个性化截骨导板辅助内侧OWHTO治疗。比较两组手术情况、并发症发生情况及手术前后创伤应激指标(C反应蛋白(Creactive Protein,CRP)、P物质(Substance P,SP)、前列腺素E(Prostaglandin,PGE))、前交叉韧带(ACL)形态和功能指标(ACL长度、体部宽度、胫骨前移量)、膝关节功能(美国膝关节协会评分(American Knee Society Knee Score,KSS)、美国特种外科医院膝关节评分(Hospital for Special Surgery Knee Score,HSS))、髋膝踝角(Hip-Knee-Ankle Angle,HKA)、胫骨近端内侧角(Medial Proximal Tibial Angle,MPTA)。结果:导板组手术时间、术中出血量、透视次数均少于对照组(P<0.05);两组术后1 d和3 d血清CRP、SP、PGE水平均高于术前,但导板组均低于对照组(P<0.05);对照组术后取内固定时ACL体部宽度低于术前,胫骨前移量高于术前(P<0.05),导板组术后取内固定时ACL体部宽度、胫骨前移量与术前比较,差异无统计学意义(P>0.05);两组术后3个月、6个月KSS、HSS评分均高于术前(P<0.05);两组术后3个月、6个月HKA、MPTA均高于术前(P<0.05);导板组并发症总发生率(13.33%)与对照组(30.00%)比较,差异无统计学意义(P>0.05)。结论:个性化截骨导板辅助OWHTO治疗KOA患者,能缩短手术时间,减轻手术创伤,降低术后创伤应激反应,且能改善ACL形态和功能,膝关节功能恢复良好,具有良好应用价值。展开更多
Main intention of the research is to understand about significance of techniques associated with HTO. This research reviewed the techniques of high tibial osteotomy namely high tibial osteotomy, open wedge high tibial...Main intention of the research is to understand about significance of techniques associated with HTO. This research reviewed the techniques of high tibial osteotomy namely high tibial osteotomy, open wedge high tibial osteotomy, closedhigh tibial osteotomy. Patients who are suffering from knee arthritis, high tibial osteotomy assists to prevent or delay the requirement for total or partial replacement of knee to preserve damaged tissue of joint. High tibial osteotomy technique is mainly suitable for active and young patients with knee osteoarthritis. Age plays a main factor in success rate of high tibial osteotomy technique. It could be done in open wedge or closed wedge high tibial osteotomy. For some cases, surgery could be done in combined method (open wedge and closed wedge high tibial osteotomy). When compared with clinical outcomes of closed wedge high tibial osteotomy and open wedge high tibial osteotomy, open wedge high tibial osteotomy performs well in reducing the pain, duration of weight-bearing and return to normal life as soon as possible.展开更多
文摘目的:探讨个性化截骨导板辅助胫骨高位截骨治疗膝关节骨性关节炎(Knee Osteoarthritis,KOA)的临床效果。方法:选取2020年5月至2021年5月60例KOA患者,采用随机数字表法分为对照组和导板组(各30例),对照组行内侧开放楔形胫骨高位截骨术(Opening Wedge High Tibial Osteotomy,OWHTO)治疗,导板组行个性化截骨导板辅助内侧OWHTO治疗。比较两组手术情况、并发症发生情况及手术前后创伤应激指标(C反应蛋白(Creactive Protein,CRP)、P物质(Substance P,SP)、前列腺素E(Prostaglandin,PGE))、前交叉韧带(ACL)形态和功能指标(ACL长度、体部宽度、胫骨前移量)、膝关节功能(美国膝关节协会评分(American Knee Society Knee Score,KSS)、美国特种外科医院膝关节评分(Hospital for Special Surgery Knee Score,HSS))、髋膝踝角(Hip-Knee-Ankle Angle,HKA)、胫骨近端内侧角(Medial Proximal Tibial Angle,MPTA)。结果:导板组手术时间、术中出血量、透视次数均少于对照组(P<0.05);两组术后1 d和3 d血清CRP、SP、PGE水平均高于术前,但导板组均低于对照组(P<0.05);对照组术后取内固定时ACL体部宽度低于术前,胫骨前移量高于术前(P<0.05),导板组术后取内固定时ACL体部宽度、胫骨前移量与术前比较,差异无统计学意义(P>0.05);两组术后3个月、6个月KSS、HSS评分均高于术前(P<0.05);两组术后3个月、6个月HKA、MPTA均高于术前(P<0.05);导板组并发症总发生率(13.33%)与对照组(30.00%)比较,差异无统计学意义(P>0.05)。结论:个性化截骨导板辅助OWHTO治疗KOA患者,能缩短手术时间,减轻手术创伤,降低术后创伤应激反应,且能改善ACL形态和功能,膝关节功能恢复良好,具有良好应用价值。
文摘Main intention of the research is to understand about significance of techniques associated with HTO. This research reviewed the techniques of high tibial osteotomy namely high tibial osteotomy, open wedge high tibial osteotomy, closedhigh tibial osteotomy. Patients who are suffering from knee arthritis, high tibial osteotomy assists to prevent or delay the requirement for total or partial replacement of knee to preserve damaged tissue of joint. High tibial osteotomy technique is mainly suitable for active and young patients with knee osteoarthritis. Age plays a main factor in success rate of high tibial osteotomy technique. It could be done in open wedge or closed wedge high tibial osteotomy. For some cases, surgery could be done in combined method (open wedge and closed wedge high tibial osteotomy). When compared with clinical outcomes of closed wedge high tibial osteotomy and open wedge high tibial osteotomy, open wedge high tibial osteotomy performs well in reducing the pain, duration of weight-bearing and return to normal life as soon as possible.
