以人工单髁关节置换术为对比研究腓骨截骨术治疗膝关节骨关节炎的早期疗效和机制

发布时间：2018-05-26 14:38

本文选题：骨关节炎 + 腓骨　；参考：《山西医科大学》2017年硕士论文

【摘要】：目的:以人工单髁关节置换术(unieom partmental knee arthroplasty,UKA)为对照,研究腓骨近端截骨术(fibular osteotomy,FO)治疗膝关节骨关节炎的早期疗效和机制。方法:根据此次试验的纳入及排除标准,连续随访2014年7月至2016年3月山西省人民医院关节外科组收治的患者65人,全部随访成功。根据其采取的手术方式,将行腓骨截骨的患者分为观察组(n=31),将行UKA的患者分为对照组(n=34)。比较观察组和对照组患者的数据,包括:(1)年龄;(2)术程用时;(3)术程出血;(4)在院时间;(5)医院扣费;(6)术前、术后3个月和12个月的西安大略和麦克马斯特大学骨关节炎指数(Western Ontario and McMaster Universities osteoarthritis index,WOMAC)、美国膝关节协会评分(knee society score,KSS)和美国特种外科医院(hospital for special surgery knee score,HSS)膝关节评分情况。结果:对所有65例患者进行12个月随访,全部获得随访成功。组内比较:与术前相比,对照组患者术后6个月、12个月的HSS评分、WOMAC评分和KSS评分都取得了明显的改善,差异有统计学意义(P0.05);在观察组,与术前相比,对照组患者术后6个月、12个月的HSS评分、WOMAC评分和KSS评分也都取得了明显的改善,差异有统计学意义(P0.05)。组间比较:在以下4项数据:a.术程用时;b.术程出血;c.医院扣费;d.在院时间:,观察组表现均比对照组更好,差异有统计学意义(P0.05)。结论:在治疗内侧间室型KOA上,腓骨近端截骨术(fibular osteotomy,FO)取得了与人工单髁关节置换术(unieom partmental knee arthroplasty,UKA)相当的临床效果,但前者治疗费用相对更低,手术创伤更小,术后下地更快,是一种很有前景、很值得推广的手术方式。
[Abstract]:Objective: to study the early curative effect and mechanism of fibulular osteotomygotomy in the treatment of knee osteoarthritis with artificial monodondylar arthroplasty (UKAA). Methods: according to the criteria of inclusion and exclusion of the trial, 65 patients in the joint surgery group of Shanxi Provincial people's Hospital from July 2014 to March 2016 were followed up successfully. Patients undergoing fibula osteotomy were divided into observation group (n = 31) and control group (n = 34). The data of patients in the observation group and the control group were compared, including the age of 1: 1) the age of 2) the duration of the operation, the bleeding during the operation and the 4) in hospital time, 5) the hospital withheld fees and 6) before operation. 3 and 12 months after operation, the osteoarthritis index of Western Ontario and the University of McMaster was evaluated by Western Ontario and McMaster Universities osteoarthritis and WOMA. The knee society score was evaluated by the American knee Association (AJA) and the for special surgery knee Scoreen HSS at the American Special surgery Hospital. Results: all 65 patients were followed up for 12 months. Intra-group comparison: compared with pre-operation, the HSS scores and KSS scores of the control group were significantly improved at 6 months and 12 months after operation, and the difference was statistically significant (P 0.05); in the observation group, there was no significant difference between before and after operation. In the control group, the HSS score, WOMAC score and KSS score were significantly improved at 6 months and 12 months after operation, and the difference was statistically significant (P 0.05). Group comparison: in the following 4 data: a. The procedure takes a long time. Bleeding during operation. The hospital withheld fees. At 1: 00, the performance of the observation group was better than that of the control group, and the difference was statistically significant (P 0.05). Conclusion: in the treatment of medial interventricular KOA, fibulular osteotomy FOO (fibular osteotomy) has achieved the same clinical effect as artificial monodondylar arthroplasty (UKAA), but the cost of the former is relatively low, the surgical trauma is smaller, and the operation is faster after operation. Is a very promising, very worthy of promotion of the operation.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

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