贵州医科大学学报

2018, v.43;No.216(09) 1065-1068+1083

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腓骨高位截骨术治疗膝骨关节炎的疗效
Clinical Effect of Upper Fibular Osteotomy on Knee Osteoarthritis

董龙家;何宇祺;张卫;
DONG Longjia;HE Yuqi;ZHANG Wei;Department of Orthopaedics,Affilliated Baiyun Hospital of Guizhou Medical University;Guizhou Medical University;

摘要(Abstract):

目的:探讨腓骨高位截骨术治疗膝关节骨性关节炎(KOA)近期临床效果。方法:选取KOA(膝关节内侧间隙变窄)患者46例,采用腓骨高位截骨术进行手术治疗,术前完善膝关节负重位X线和视觉模拟评分法(VAS)评估疼痛程度;采用美国特种外科医院膝关节评分系统(HSS)评估患者膝关节的疼痛、功能、活动度、肌力、屈曲畸形及关节稳定性;美国膝关节协会评分系统(KSS)评估患者膝关节在疼痛、活动度、关节稳定性、行走能力及上下楼等方面情况。结果:患者术后1 d、术后1月、术后1年时关节疼痛程度较术前逐渐减轻,膝关节功能明显好转,差异有统计学意义(P <0. 05);除KSS评分中膝关节稳定性在术后1 d与术前比较、术后1月与术后1 d比较,差异无统计学意义(P> 0. 05),HSS、KSS评分其他分项指标中各时间点评分比较,差异有统计学意义(P <0. 05)。结论:腓骨高位截骨术治疗膝关节骨关节炎效果显著。
Objective: To investigate the recent clinical effect of high fibular osteotomy on knee osteoarthritis( KOA). Methods: 46 patients with KOA( narrowing of the inner knee joint) were treated with high fibular osteotomy. Preoperative assessment include: weight-bearing radiographs were taken and preoperative and postoperative pain intensity were evaluated according to visual analog scale( VAS) score t; Hospital for Special Surgery( HSS) was used to assess knee pain,function,mobility,muscle strength,flexion deformity,and joint stability; American Knee Society Rating System( KSS)was used to assess knee pain,mobility,joint stability,walking ability and other aspects. Results: The joint pain intensity was gradually decreased one day,one month and one year respectively after the operation. The knee function was significantly improved( P < 0. 05). Among sub-indicators of HSS and KSS scores,only the comparison of knee stability between postoperative day one and postoperative time and between postoperative day one and one month after the operation had no statistically significance( P > 0. 05). Conclusion: High fibula osteotomy on knee osteoarthritis is effective and can be used as an effective treatment for knee osteoarthritis.

关键词(KeyWords): 骨关节炎,膝;腓骨;外科手术;截骨术;不均匀沉降;治疗效果
osteoarthritis,knee;fibula;surgical procedures,operative;osteotomy;unevenly sink;curative effect

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基金项目(Foundation): 贵州省科技计划项目[黔科合LH字(2016)7403]

作者(Author): 董龙家;何宇祺;张卫;
DONG Longjia;HE Yuqi;ZHANG Wei;Department of Orthopaedics,Affilliated Baiyun Hospital of Guizhou Medical University;Guizhou Medical University;

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