胫骨高位截骨治疗膝关节骨关节炎并膝内翻

目的探讨胫骨高位截骨Giebel钢板内固定治疗膝关节骨关节炎并膝内翻的临床效果。方法从2008年8月至2012年2月,我科实施胫骨高位截骨Giebel钢板内固定手术治疗膝关节骨关节炎并膝内翻患者38例47膝。所有患者均以内侧间室疼痛为主。其中男13例15膝,女25例32膝;年龄36~58岁,平均48.5岁;应用HSS膝关节评分系统进行分析。结果 38例均获随访,随访18~24个月,平均20.2个月。术后未出现伤口感染、钢板螺钉断裂、膝内翻复发、骨不愈合等并发症。截骨处在术后12~14周均达到骨性愈合,疼痛症状均明显缓解或消失,摄片检查力线维持在术后水平。膝胫骨角术前平均为（102.1±4.3）°,术后平均为（91.5±4.1）°,所得资料采用配对t检验进行统计学分析,P〈0.01,具有明显的统计学差异。采用HSS膝关节评分标准进行疗效评价,优24膝,良16膝,中5膝,差2膝,优良率85.1%。结论胫骨高位截骨Giebel钢板内固定术式简单,组织创伤小,手术时间短,并发症少,患者下床活动早,功能恢复快,效果满意,是一种治疗膝内翻并膝关节骨性关节炎的良好方法。

High Tibial Osteotomy and Fixation with Giebel Plate for Osteoarthritis of the Knee Associated with Varus

Objective To investigate the clinical effect of the treatment of high tibial osteotomy and fixation with Giebel plate for osteoarthritis of the knee associated with varus.Methods From August 2008to February 2012,we treated 38cases（47knees）,Including 13males（15knees）and 25females（32knees）;aged from 36to 58years,mean 48.5years.All patients felt pain mainly in medial aside of the knee.We analyzed the data with HSS knee scoring system.Results 38patients were followed up,from 18to 24months with an average of 20.2months.There were no complications.All tibia healed after 12~14weeks.Pain symptoms were relieved or disappeared.Lines of force remained at the postoperative radiography.The preoperative knee tibial angle were（1 0 2.1±4.3）°before operation and（9 1.5± 4.1）°after operation.Resulting data were analyzed by paired t-test（P0.01）.Accordinging to HSS knee scoring cystem,there were excellent in 24knees,fine in 16knee and poor in 2knee.Excellent rate is 85.1%.Conclusion The high tibial osteotomy and Giebel plate fixation which has good simple surgical tissue trauma,shorter operative time,fewer complications,early ambulation and quick recovery of function,is a good choice for osteoarthritis of the knee associated with varus.