摘要
目的探讨胫骨高位截骨术(HTO)联合关节镜下膝关节清理术治疗老年膝关节内侧单间室骨性关节炎患者的临床效果。方法将100例老年膝关节内侧单间室骨性关节炎患者随机分为对照组和观察组,各50例。对照组患者采用关节镜下膝关节清理术治疗,观察组患者采用HTO联合关节镜下膝关节清理术治疗。比较两组患者术后6个月的临床疗效、治疗前后的疼痛程度[视觉模拟量表(VAS)评分]、日常生活活动能力量表(ADL)评分、术前及术后3 d炎症因子[肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、前列腺素E_(2)(PGE_(2))]水平及术后6个月生活质量综合评定问卷(GQOLI-74)评分,并对比两组患者术后6个月并发症发生率。结果治疗后,观察组治疗优良率高于对照组,两组患者的疼痛VAS评分及血清TNF-α、IL-1β、PGE_(2)水平均低于治疗前,ADL评分均高于治疗前,且观察组上述指标改善均优于对照组(均P<0.05);观察组GQOLI-74各项评分及总分均高于对照组,并发症发生率低于对照组(均P<0.05)。结论相较于单纯关节镜下膝关节清理术,HTO联合关节镜下膝关节清理术治疗老年膝关节内侧单间室骨性关节炎患者能更有效地减轻疼痛,降低并发症的发生率,降低患者血清炎症因子表达水平,提高治疗效果及日常生活能力。
Objective To explore the clinical efficacy of high tibial osteotomy(HTO)combined with arthroscopic knee debridement for the treatment of medial unicompartmental knee osteoarthritis in elderly patients.Methods A total of 100 elderly patients with medial unicompartmental knee osteoarthritis were randomly divided into control group(n=50)and observation group(n=50).Patients in the control group were treated with arthroscopic knee debridement,and patients in the observation group were treated with HTO combined with arthroscopic knee debridement.Clinical efficacy six months after the operation,pre-and post-treatment pain degree(the Visual Analogue Scale[VAS]score)and Activities of Daily Living(ADL)score,and inflammatory factors(tumor necrosis factorα[TNF-α],interleukin 1β[IL-1β],prostaglandin E_(2)[PGE_(2)])levels before the operation and on day 3 after the operation,as well as the Generic Quality of Life Inventory 74(GQOLI-74)score six months after the operation,were compared between the two groups;in addition,the incidence rate of postoperative complications six months after the operation was compared between the two groups.Results After treatment,the observation group yielded an excellent and good rate for treatment than the control group,the VAS pain score and serum TNF-α,IL-1βand PGE_(2) levels were lower and the ADL score was higher in both groups as compared with those before treatment,and the observation group was superior to the control group in the improvements in the aforementioned indices(all P<0.05);the observation group exhibited higher scores for all items of GQOLI-74 and total score,a lower incidence rate of complications than the control group(all P<0.05).Conclusion Compared with arthroscopic knee debridement alone,HTO combined with arthroscopic knee debridement can ameliorate pain more effectively,reduce the incidence rate of complications,decrease expression levels of serum inflammatory factors,and improve therapeutic effects and activities of daily living in the treatment of elderly patients with medial unicompartmental knee osteoarthritis.
作者
张猛
敖阳
郑红艳
ZHANG Meng;AO Yang;ZHENG Hong-yan(Department of Orthopaedics,Fuxin Hospital of Traditional Chinese Medicine,Fuxin 123000,China;Operating Room,Fuxin Hospital of Traditional Chinese Medicine,Fuxin 123000,China)
出处
《广西医学》
CAS
2021年第19期2288-2292,共5页
Guangxi Medical Journal
基金
辽宁省卫生和计划生育委员会科研项目(20174Z0120)。
