膝关节骨性关节炎并膝内翻行胫骨高位截骨术临床疗效与人体质量指数关系的研究

目的：探讨膝骨性关节炎并膝内翻行胫骨高位截骨手术的临床疗效与人体质量指数(BMI)间的关系。方法：研究对象为住院行胫骨高位截骨手术的膝关节骨性关节炎并膝内翻的患者，共110例(136膝)。术前记录患者身高、体重，并记算BMI(体重／身高^2，kg／m^2)。根据日本骨科学会膝关节损伤功能评分标准评出患者术前及术后的膝关节功能总分。将BMI与术前及术后评分进行相关分析。结果：BMI与术前及术后的评分之间存在线性相关。手术前后评分之差与BMI间的回归系数b=-1．79，有统计学意义(P＜0．01)，且|b|＞1，说明手术前后的评分之差受BMI的影响，BMI越小者，手术前后评分差越大，反之评分差越小。术后的评分与，BMI间相关系数r=-0．715，回归系数b=-2．63，说明BMI越大，评分越低。当术后评分等于75．00时，BMI=24．00，其95％的CI为(23．60833，24．30760)。结论：BMI越大，即肥胖，是影响胫骨高位截骨手术疗效的不利因素，可取BMI≤24为手术适应证的标准。

Correlation between surgical outcomes and body mass index in patients with osteoarthritis of the knee combined with genu varum treated by high tibial osteotomy

Objective:To investigate the correlation between surgical outcomes and body mass index(BMI) in patients who underwent high tibial osteotomy for osteoarthritis of the knee with genu varum.Methods:One hundred and ten patients(136 knees)underwent operative treatment for high tibial osteotomy were followed up consecutively.The height and body weight of each patient was measured and recorded preoperatively.The BMI was calculated by the following formula.BMI=weight/height2(kg/m2).A questionnaire evaluation form was designed according to the 6 scoring standards put forward by Japanese Orthopaedic Association.To analyze BMI with preoperatively and postoperatively scoring.Results:Linear correlation was between BMI and scoring.There was statistical significance(P<0.01,|b|>1)between minus of scoring and coneficient(b=-1.79)in BMI.The minus of scoring was significantly influenced by BMI.The less BMI was,the higher the minus of scoring was.The postoperatively scoring was seventy-five and BMI was 24.00,there was ninety-five percent of CI showed(23.608 33,24.307 60).Conclusion:Highter BMI or obesity exerts negative influence on the results of operative treatment of high tibial osteotomy.The BMI not more than 24 is the standard of indication of surgery.