腓骨中上段截骨治疗不均匀沉降性膝关节骨关节炎效果

发布时间：2018-07-15 20:38

【摘要】：目的评估腓骨中上段截骨治疗不均匀沉降性膝关节骨关节炎(KOA)的手术效果。方法 76例(92膝)明确诊断为胫骨近端不均匀沉降性KOA患者,给予腓骨中上段截骨,切除长度1.5~2 cm。通过视觉疼痛模拟评分(VAS)、美国膝关节协会评分(KSS)评估手术前后膝关节功能恢复、患者满意度及并发症发生情况,X线观察术前术后关节间隙变化情况。结果随访1~13(平均7.3)个月,VAS、KSS术前术后差异有统计学意义(P0.01)。患者满意度优良86膝(93.5%)。X线测量短期临床影像改善59膝(64.1%)。结论腓骨截骨通过力学原理恢复膝关节周围软组织平衡,不干扰膝关节内在稳定性,可以有效缓解KOA所致的疼痛,该术式具有创伤小、恢复快、并发症少等优点,避免了胫骨高位截骨内固定、人工膝关节置换假体植入手术并发症。
[Abstract]:Objective to evaluate the effect of middle and upper fibula osteotomy in the treatment of uneven subsidence osteoarthritis of knee (KOA). Methods Seventy-six patients (92 knees) with nonuniform proximal tibial subsidence were treated with middle and upper fibula osteotomy. The length of osteotomy was 1.52cm. Visual pain analogue score (VAS) and American knee Association score (KSS) were used to evaluate the recovery of knee joint function, patient satisfaction and complications before and after operation. Results there was a significant difference between preoperative and postoperative follow-up of VAS-KSS at 1: 13 (mean 7.3) months (P0.01). Satisfactory rate of patients was excellent in 86 knees (93.5%). X ray was used to measure short-term clinical imaging improvement in 59 knees (64.1%). Conclusion the fibula osteotomy can effectively relieve the pain caused by KOA by restoring the soft tissue balance around the knee joint on the basis of mechanics principle and without interfering with the internal stability of the knee joint. It has the advantages of less trauma, faster recovery and fewer complications. The high tibial osteotomy and internal fixation were avoided, and the complications of artificial knee arthroplasty and prosthesis implantation were avoided.
【作者单位】：郑州市骨科医院骨肿瘤骨病Ⅰ科;
【分类号】：R687.4

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