腓骨截骨治疗膝骨性关节炎的近期效果研究

目的 :探讨腓骨截骨手术对膝骨性关节炎患者的近期临床治疗效果。方法 :自2015年1月起,收治以内侧间隙疼痛为主要表现的膝骨性关节炎患者12例(15膝);均为女性患者,平均年龄61.3岁。均采用腓骨截骨手术,对其膝骨性关节炎进行治疗。术后早期下地适当进行关节活动,对患者手术前后进行相应影像学评估,测量膝关节内外间室高度变化情况。观察并记录术前、术后2 d、术后2个月VAS、KSS、HSS评分,分析各项指标变化情况。结果:患者住院天数(6.0±2.4)d;单侧手术时间(33.3±8.4)min,术中均无明显出血。术后均未出现伤口感染、延迟愈合及神经损伤等并发症。所有患者于术后1 d下地行走,主诉原有膝关节内侧间隙疼痛明显好转或消失。患者手术后2 d与术前相比,VAS、HSS及KSS临床评分均较术前改善;手术后2个月与术前相比,VAS、HSS、KSS临床评分及功能评分均较术前改善。术后2 d复查膝关节负重位X线片,与术前膝关节负重位X线片比较,均出现不同程度膝关节内侧间隙增高。结论:腓骨截骨术手术操作简单,创伤小,术后疼痛减轻明显,关节功能恢复良好,是治疗骨性关节炎膝内翻的有效方法。

A short-term clinical study of fibular osteotomy for knee osteoarthritis

Objective: To study clinical effects of fibular osteotomy for the treatment of knee osteoarthritis.Methods: From January 2015,12 patients (15 knees) with knee osteoarthritis were treated with fibular osteotomy. The main symptom was interval inside pain. All the patients were female with an average age of 61.3 years old. Early postoperative ambulation of joints was carried out after surgery,and the corresponding radiographic assessment before and after operations were performed with record. Finally,the following indicators were analyzed:VAS,KSS,HSS,respectively before,2 days and 2 months after the operation.Results: The average hospitalization time was (6.0±2.4) days,and the time of unilateral operation was (33.3±8.4) minutes without significant bleeding. There were no obvious complications such as wound infection,delayed healing and nerve damage. All the patients could walk around 1 day after operations with a chief complaint of the obvious reduction or disappear of the interval medial knee pain. The VAS score,HSS score and KSS clinical score were significantly improved 2 days after surgery compared to the scores before operation. These above scores and functional score were significantly improved 2 months after operation compared to the scores before operation. X-ray films of the weight-bearing knees were taken 2 days after surgery,showing increased height of medial joint space to some extent compared to that before operation.Conclusion: A fibular osteotomy has been proved to significantly reduce the postoperative pain and facilitate the good recovery of joint function with the advantages of simple surgical procedures and slighttrauma. Therefore,it is an effective method for the treatment of knee osteoarthritis with varus deformity.