腓骨截骨术和膝关节镜下清理术联合补肾祛痛方治疗内翻型膝骨关节炎疗效观察

目的观察腓骨截骨术和膝关节镜下清理术联合补肾祛痛方治疗内翻型膝骨关节炎(KOA)的临床疗效。方法将60例内翻型KOA患者按随机数字表法分为2组。对照组30例采用膝关节镜下清理术治疗;治疗组30例在对照组基础上予腓骨截骨术,术后采用中药补肾祛痛方治疗2周。分别比较2组术前、术后2周、术后3个月疼痛视觉模拟评分(VAS)、美国特种外科医院(HSS)膝关节评分及膝内翻角度,并统计疗效。结果治疗组总有效率96.67%(29/30),对照组总有效率66.67%(20/30),治疗组疗效优于对照组(P<0.05)。2组术后2周及术后3个月膝关节内翻角度较本组术前均减小(P<0.05),治疗组术后3个月膝关节内翻角度小于术后2周(P<0.05);治疗组术后2周及术后3个月膝关节内翻角度均小于对照组同期(P<0.05)。2组术后2周及术后3个月疼痛VAS较本组术前均降低(P<0.05),HSS膝关节评分较本组术前均升高(P<0.05);2组术后3个月疼痛VAS均低于术后2周(P<0.05),HSS评分均高于术后2周同期(P<0.05)。治疗组术后2周及术后3个月疼痛VAS均低于对照组同期(P<0.05),HSS膝关节评分均高于对照组同期(P<0.05)。结论腓骨截骨术和膝关节镜下清理术联合中药补肾祛痛方内服治疗内翻型KOA疗效显著,能有效缓解疼痛,改善膝关节功能。

Clinical effect of fibular osteotomy and knee arthroscopic debridement combined with Bushen Qutong recipe in the treatment of varus knee osteoarthritis

Objective To observe the effect of fibular osteotomy and knee arthroscopic debridement combined with Bushen Qutong recipe in the treatment of varus knee osteoarthritis(KOA).Methods 60 patients with KOA were randomly divided into two groups according to the random number table method.30 cases in control group were treated by knee arthroscopic debridement.30 cases in treatment group were treated by fibular osteotomy on the basis of the control group,and the patients were treated by Bushen Qutong recipe for 2 weeks after operation.The pain visual analogue score(VAS),the knee joint score of American special surgery hospital(HSS)and the angle of genu varus were compared before operation,2 weeks after operation and 3 months after operation between the two groups.The efficacy of the two groups was counted.Results The total effective rate was 96.67%(29/30)in the treatment group and 66.67%(20/30)in the control group.The clinical curative effect of the treatment group was better than that of the control group(P<0.05).The knee joint varus angle of the 2 groups was reduced at 2 weeks and 3 months after operation(P<0.05).The knee joint varus angle of the treatment group at 3 months after operation was less than that at 2 weeks after operation(P<0.05).The knee joint varus angle of the treatment group was less than that of the control group at 2 weeks and 3 months after operation(P<0.05).In both groups,the pain VAS was decreased at 2 weeks and 3 months after operation(P<0.05),and the HSS score was increased(P<0.05).The pain VAS at 3 months after operation in both groups was lower than that at 2 weeks after operation(P<0.05),and the HSS score was higher than that at 2 weeks after operation(P<0.05).The pain VAS of the treatment group was lower than that of the control group at 2 weeks and 3 months after operation(P<0.05),and the HSS score was higher than that of the control group(P<0.05).Conclusion The fibular osteotomy and knee arthroscopic debridement combined with Bushen Qutong recipe is effective in the treatment of KOA with varus,which can effectively relieve pain and improve knee joint function.