摘要
目的比较腓骨近端截骨术及胫骨高位截骨术（high tibial osteotomy,HTO）治疗内翻型膝关节骨关节炎的临床疗效.方法回顾性分析2010 年6 月至2015 年6 月山西医科大学附属人民医院收治的符合纳入及排除标准的膝关节骨关节炎患者56 例,根据手术方式不同分为腓骨截骨组（n=29）和HTO 组（n=27）.随访并比较两组患者的手术时间、术中出血量、住院天数、住院费用及术前、术后3 个月和6 个月的疼痛视觉模拟评分（visual analogue scale,VAS）、美国特种外科医院（hospital for special surgery,HSS）膝关节评分和美国膝关节协会评分（knee society score,KSS）.结果56 例患者均获得成功随访,随访时间为6 ～ 60 个月,平均（6.6±1.1）个月.与HTO组患者相比,腓骨截骨组患者的手术时间、术中出血量、住院费用、住院时间、切口长度均较少,差异有统计学意义（P 〈 0.05）.两组间术前及术后3 个月、6 个月膝关节VAS、HSS 和KSS 评分比较,差异均无统计学意义（P 〉 0.05）;两组患者术后3 个月、6 个月的VAS、HSS 和KSS 评分较术前均有明显改善,差异有统计学意义（P 〈 0.05）.结论腓骨近端截骨术治疗膝关节骨关节炎的短期疗效与HTO 相当,但其创伤小、恢复快、花费少,是一种可选的治疗膝关节骨关节炎的手术方式.
ObjectiveTo compare the clinical effect of proximal fibular osteotomy and hightibial osteotomy （high tibial osteotomy, HTO） in the treatment of varus knee osteoarthritis. MethodsA retrospective analysis was performed on 56 patients with knee osteoarthritis who met the inclusion andexclusion criteria and were treated in the Affiliated People＇s Hospital of Shanxi Medical University fromJune 2010 to June 2015. The patients were divided into fibular osteotomy group （n=29） and HTO group（n=27） according to different surgery type. All patients were well followed-up, before and after operation（3, 6 months） The operative time, peri-operative bleeding, hospitalization time, hospitalization expenses, thevisual analogue scale （VAS） , hospital for special surgery knee score （HSS）, and knee society score （KSS） ofeach patient were recorded and compared between these two groups. Results56 patients were followed-upfor 6 to 60 months, with an average of 6.6±1.1 months, and all cases obtained satisfactory results. Comparedwith the HTO group, the operative time, hospitalization time, hospitalization expenses, hospitalization time,length of incision, and the length of incision were all lower than the fibular osteotomy group. The differencewas statistically significant （P〈0.05）. While no significant differences were observed in the KSS, HSS andVAS scores at preoperation, 3 months and 6 months follow-up （P〉0.05）. Intra-group comparison： the KSS,HSS and VAS scores of postoperation of the two groups were all significantly higher than preoperation, andthe difference was statistically significant （P〈0.05）. ConclusionThe clinical effect of proximal fibularosteotomy and high tibial osteotomy is equivalent in treating knee osteoarthritis, however the proximalfibula osteotomy has advantages of small trauma, quick recovery, low cost, which is an alternative treatmentfor knee osteoarthritis.
出处
《中华老年骨科与康复电子杂志》
2016年第2期97-102,共6页
Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)
基金
山西省科技厅项目(20150313012-3)
关键词
膝关节
骨关节炎
腓骨
截骨术
Knee joint
Osteoarthritis
Fibula
Osteotomy
