Ilizarov技术治疗中老年膝骨关节炎内侧间室疼痛的临床观察

发布时间：2019-04-26 13:15

【摘要】：目的探讨胫骨结节下微创截骨,Ilizarov技术牵伸矫形,治疗中老年膝骨关节炎内侧间室疼痛的效果。方法回顾分析2012年4月至2013年10月,采用Ilizarov技术牵伸治疗的34例患者,共计48个膝关节(14人双膝治疗)。其中,男11例,女23例;年龄51到76岁,平均65.7岁。病程2~15年,平均病程为5.1年,症状均以膝内侧间室疼痛为主的膝骨关节炎患者。均有2年以上中、西医结合治疗病史。测量膝关节活动范围(142.0±9.3)°,并根据KSS评分评判患膝功能。34例患者术前均拍双下肢全长X线片,测量双下肢力线移位程度及股胫夹角(FTA)。采用胫骨结节下2~3cm处截骨,安装Ilizarov环形外固定支架。术后第5天行牵伸成骨矫形,10~15d后,拍双下肢X线片,确定下肢力线及股胫夹角达到正常值后,锁定外固定支架。要求扶拐行走锻炼,待截骨端成骨完全钙化达到骨性愈合,约12~16w后,拆除外固定支架。结果 34例患者平均13.8w拆外固定支架;所有患者均获18~36个月随访,平均18.7个月,并行膝关节KSS评分。结论胫骨结节下微创截骨,Ilizarov环形外固定支架牵伸矫正,治疗中老年膝骨关节炎内侧间室疼痛,具有矫正准确、疗效确切、微创伤、成骨矫形等特点。
[Abstract]:Objective to investigate the effect of minimally invasive osteotomy under tibial tubercle and Ilizarov technique in the treatment of medial interventricular pain of knee osteoarthritis in middle-aged and elderly patients. Methods from April 2012 to October 2013, a total of 48 knee joints (14 knees) were treated by Ilizarov technique in 34 patients. There were 11 males and 23 females, aged from 51 to 76, with an average of 65.7 years. The course of disease ranged from 2 to 15 years, with an average course of 5.1 years. The symptoms were mainly pain in the medial compartment of the knee in patients with osteoarthritis of the knee. There were more than 2 years of history of western medicine combined with treatment. The range of knee motion was measured (142.0 卤9.3o) 掳, and the knee function was evaluated according to the KSS score. The full-length X-ray films of both lower limbs were taken before operation in 34 patients, and the degree of force line displacement and the angle of femur and tibia (FTA). Were measured in 34 patients. 2~3cm osteotomy was performed at the inferior tibial tubercle and Ilizarov ring external fixator was installed. After 10 days, X-ray films of lower extremities were taken to determine the force line of lower extremities and the angle between femur and tibia reached the normal value, then the external fixator was locked. After 12 weeks and 16 weeks, the external fixator was removed. Results all 34 patients were followed up for 18 months (average 18.7 months), and all patients were followed up for 18 months (average 18.7 months) with KSS score of knee joint. Conclusion minimally invasive osteotomy under tibial tubercle and Ilizarov circular external fixator for the treatment of medial interventricular pain in middle-aged and elderly knee osteoarthritis have the characteristics of accurate correction, definite curative effect, micro-trauma, osteogenic correction, etc. [WT5 "HZ] conclusion [WT5" BZ] [WT5 "BZ]
【作者单位】：广州中医药大学附属佛山中医院佛山市中医院;国家康复医院;北京中医药大学基础医学院;
【基金】：佛山市院市合作项目(2012HY100631) 佛山市高校和医院科研基础平台建设项目(2013AG10009) 国家自然科学基金资助项目(NSFC81273995)
【分类号】：R687.4

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