胫骨高位双平面截骨术治疗膝内侧间室骨关节炎

目的探讨胫骨高位双平面截骨术治疗膝内侧间室骨关节炎的近期疗效。方法采用胫骨高位双平面截骨术治疗37例膝内侧间室骨关节炎患者。测量手术前后膝关节站立负重位X线片胫股解剖角、髋—膝—踝角,记录手术前后膝关节损伤和骨关节炎KOOS评分、KSS评分和疼痛VAS评分。结果患者均顺利完成手术。术后未出现感染、骨筋膜室综合征、腓总神经损伤、下肢深静脉血栓等并发症,截骨处愈合良好,患者膝内翻畸形情况均得到矫正。37例均获得随访,时间6~30(18.6±7.0)个月。胫股解剖角、髋—膝—踝角、KOOS评分、KSS评分、VAS评分术后3个月较术前明显改善,差异均有统计学意义(P<0.001)。结论胫骨高位双平面截骨术治疗膝内侧间室骨关节炎能够纠正下肢异常力线,缓解或者消除膝关节疼痛症状,短期疗效满意。

Double-plane high tibial osteotomy for the treatment of knee medial compartment osteoarthritis

Objective To investigate the short-term clinical efficacy of double-plane high tibial osteotomy in the treatment of knee medial compartment osteoarthritis.Methods A total of 37 patients with knee medial compartment osteoarthritis were treated with double-plane high tibial osteotomy.At the pre-and post-operation,the tibiofemoral angle(TFA),hip-knee-ankle angle(HKA)of knee joint at the stand weight-bearing position on X-ray film were measured,and the KOOS score and KSS,pain VAS were recorded.Results All the patients were successfully completed the operation.No serious complications such as infection,osteofascial compartment syndrome,and common peroneal nerve injury,deep venous thrombosis of lower extremities occurred after the operation;the bone healing at the osteotomy site was good,and the postoperative knee varus deformity was corrected.The 37 cases were followed up for 6~30(18.6±7.0)months.And the TFA,HKA,KOOS,KSS and VAS were significantly improved at postoperative 3 months,compared with the preoperation,there were statistical differences(P<0.001).Conclusions Double-plane high tibial osteotomy can correct the distribution of abnormal strength lines in the treatment of knee medial compartment osteoarthritis,which can relieve or eliminate the symptoms of knee joint pain,the short-term efficacy is satisfactory.