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陈涯1,许长鹏1,王法正2,杨青坡2,李路2,欧栓机1,黄帅1,颜飞华2,齐勇1▲.腓骨近端截骨术与关节镜清理联合对膝关节内侧间室骨关节炎的治疗效果探讨[J].中国医药科学,2019,(16):5-8        基金项目:新疆维吾尔自治区科技支疆项目计划(指 令性)项目(2018E02056);广东省清远市科技计划项目(2017A019)
腓骨近端截骨术与关节镜清理联合对膝关节内侧间室骨关节炎的治疗效果探讨
Treatment effect of proximal fibular osteotomy combined with arthroscopic debridement on medial compartment osteoarthritis of knee joint
  
DOI:
中文关键词:  腓骨近端截骨术;关节镜清理;膝关节内侧间室骨关节炎
英文关键词:Proximal fibular osteotomy; Arthroscopic debridement; Medial compartment osteoarthritis of knee joint
作者单位
陈涯1,许长鹏1,王法正2,杨青坡2,李路2,欧栓机1,黄帅1,颜飞华2,齐勇1▲ 1. 广东省第二人民医院关节外科,广东广州 510317;2. 新疆维吾尔自治区喀什地区第一人民医院运动医学科,新疆喀什 844000 
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中文摘要:
      [摘要] 目的 分析膝关节内侧间室骨关节炎患者应用腓骨近端截骨术与关节镜清理联合治疗的效果。方法 2015 年 9 月~ 2018 年 5 月在我院接受膝关节内侧间室骨关节炎治疗的患者中随机选取 51 例,通过随机抽签法将所选研究对象分为比照组(n=21)和探析组(n=30),比照组患者接受关节镜下关节腔清理术,探析组患者接受腓骨近端截骨术与关节镜清理联合治疗。结果 术前两组患者 HSS 评分以及 VAS 评分差异均无统计学意义(P> 0.05),术后两组患者 HSS 评分均明显高于术前,VAS 评分均明显较术前低,两组 HSS 评分以及 VAS 评分差异均有统计学意义(P < 0.05),术后探析组患者 HSS 评分明显高于比照组患者,VAS 评分明显低于比照组,两组差异均有统计学意义(P < 0.05)。术前两组患者 FTA 角度差异无统计学意义(P > 0.05),术后探析组患者 FTA角度获得明显改善,手术前后差异有统计学意义(P < 0.05),手术前后比照组患者 FTA 角度差异无统计学意义(P > 0.05),术后探析组患者 FTA 角度明显优于比照组患者,两组差异有统计学意义(P < 0.05)。比照组出现并发症患者共计 6 例,总发生率为 28.57%,探析组出现并发症患者共计 3 例,总发生率为 10%,两组并发症总发生率差异有统计学意义(P < 0.05)。结论 膝关节内侧间室骨关节炎患者应用腓骨近端截骨术与关节镜清理联合治疗能够使其膝关节功能得到明显改善,可减轻其疼痛感且具有更高的手术治疗安全性。
英文摘要:
      [Abstract] Objective To analyze the treatment effect of proximal fibular osteotomy combined with arthroscopic debridement in the treatment of medial compartment osteoarthritis of knee joint. Methods From September 2015 to May 2018, 51 patients with medial compartment osteoarthritis of the knee joint in our hospital were randomly selected, all them were divided into control group (n=21) and exploration group (n=30) by random drawing. The control group received arthroscopic debridement of the joint cavity, and the exploration group received proximal fibula osteotomy combined with arthroscopic debridement. Results There was no significant difference in HSS score and VAS score between the two groups before operation (P > 0.05). HSS score of the two groups after operation were significantly higher than those before operation, VAS score of the two groups were significantly lower than those before operation, there were significant differences in HSS score and VAS score between the two groups (P < 0.05). After operation, HSS score of exploration group was significantly higher than that of the control group, VAS score of exploration group was significantly lower than that of the control group, and the difference between the two groups was statistically significant (P < 0.05). There was no significant difference in FTA angle between the two groups before operation (P > 0.05). The FTA angle of the exploration group was significantly improved after operation than that before operation (P < 0.05). There was no significant difference in FTA angle of the control group before and after operation (P > 0.05). The FTA angle of the exploration group after operation was significantly better than that of the control group, the difference between two groups was statistically significant (P < 0.05). The total incidence of complications was 28.57% (6 cases) in the control group and 10% (3 cases) in the exploration group, there was significant difference in the total incidence of complications between the two groups (P < 0.05). ConclusionThe application of proximal fibular osteotomy combined with arthroscopic debridement in the treatment of medial compartment osteoarthritis of the knee joint can significantly improve the knee joint function, alleviate the pain and improve the safety of surgical treatment.
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