腓骨近端截骨术与人工全膝关节置换术治疗内翻型膝关节骨关节炎的短期疗效比较

发布时间：2018-09-18 09:08

【摘要】：目的比较腓骨近端截骨术与人工全膝关节置换术(total knee replacement,TKA)治疗内翻型膝关节骨关节炎的短期疗效。方法回顾性分析2015年4月至2015年7月内蒙古自治区赤峰市医院骨科接受腓骨近端截骨术与TKA治疗的内翻型膝关节骨关节炎患者共103例,符合纳入及排除标准的共85例。根据接受的术式不同分为腓骨截骨组和TKA组。腓骨截骨组患者40例,男11例(27.5%),女29例(72.5%),年龄48~78岁,平均(65.4±8.6)岁;TKA组患者45例,男14例(31.1%),女31例(68.9%),年龄52~81岁,平均(64.3±7.6)岁。分别于术前、术后7d、1个月、2个月、3个月随访并比较两组患者手术前后疼痛视觉模拟评分(visual analogue scale,VAS)、美国特种外科医院(hospital for special surgery,HSS)膝关节评分、血红蛋白、总失血量、输血量、手术时间、住院时间、住院期间总花费及观察术后并发症情况。结果 85例患者获得满意随访,随访时间3~5个月。与TKA组患者相比,腓骨截骨组患者的总出血量、输血量、手术时间、住院时间、总花费较少(P0.05);与术前相比,术后两组患者的HSS评分均明显升高、VAS评分均显著降低(P0.05),VAS和HSS评分的组间比较差异无统计学意义(P0.05);术后TKA组患者的血红蛋白含量明显降低(P0.05),腓骨截骨组患者的血红蛋白含量无显著变化(P0.05)。结论腓骨近端截骨术可获得与TKA相似的近期疗效,且具有创伤小、失血少、花费低、手术及住院时间短等优点,值得临床推广。
[Abstract]:Objective to compare the short-term efficacy of fibula proximal osteotomy and total knee arthroplasty (total knee replacement,TKA) in the treatment of varus knee osteoarthritis. Methods from April 2015 to July 2015, 103 patients with varus knee osteoarthritis treated with fibula proximal osteotomy and TKA were analyzed retrospectively, and 85 patients met the criteria of inclusion and exclusion. The fibula osteotomy group and the TKA group were divided into two groups according to the different operative methods. There were 40 patients in fibula osteotomy group, 11 males (27.5%) and 29 females (72.5%). The average age of TKA group was (65.4 卤8.6) years old, with a mean age of (65.4 卤8.6) years. There were 14 males (31.1%) and 31 females (68.9%), with a mean age of (64.3 卤7.6) years. The patients were followed up 7 days, 1 month, 2 months and 3 months before and after operation respectively. The pain visual analogue score (visual analogue scale,VAS), the knee joint score (hospital for special surgery,HSS), hemoglobin, total blood loss, blood transfusion volume were compared between the two groups before and after operation. Operation time, total cost during hospitalization and postoperative complications were observed. Results 85 patients were followed up satisfactorily for 3 ~ 5 months. Compared with the TKA group, the total blood loss, blood transfusion, operation time, hospital stay in the fibula osteotomy group were less than those in the fibular osteotomy group (P0.05). The HSS scores of the two groups were significantly increased after operation (P0.05). There was no significant difference between the VAS and HSS scores (P0.05), the hemoglobin content in the TKA group was significantly lower (P0.05), and the blood red in the fibula osteotomy group was significantly lower than that in the fibula osteotomy group (P0.05). There was no significant change in protein content (P0.05). Conclusion the proximal fibula osteotomy is similar to TKA and has the advantages of less trauma, less blood loss, low cost, short operation and hospital stay, etc. It is worthy of clinical promotion.
【作者单位】：内蒙古自治区赤峰市医院骨关节科;华中科技大学同济医学院附属协和医院骨科;
【基金】：国家自然科学基金青年基金项目(30901523)
【分类号】：R687.4

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