腓骨近端截骨术治疗内侧间室膝骨关节炎的短期效果

目的观察分析腓骨近端截骨术与人工全膝关节置换术治疗内侧间室膝骨关节炎的短期效果差异。 方法回顾2018年1月至2019年12月间于赤峰宝山中医医院骨科接受腓骨近端截骨术(PFO)和人工全膝关节置换术(TKA)治疗的患者，符合内侧间室膝骨关节炎的诊断且Kellgren-Lawrence分级为Ⅲ、Ⅳ级，排除膝关节内畸形及其他影响关节功能的疾病，排除严重内科疾病及外翻畸形，临床资料完整者。其中接受PFO共55例，纳入观察组，同期接受TKA的55例纳入对照组，统计两组的手术时间、切口长度、术中出血量、住院时间、住院费用，采用t检验进行比较；统计术前及术后3个月的疼痛视觉模拟评分(VAS评分)、美国特种外科医院膝关节评分(HSS评分)、西安大略和麦克马斯特大学膝关节炎评分(WOMAC评分)、生活质量问卷评分(SF-36评分)，组内及组间比较采用t检验。 结果观察组手术时间、切口长度、术中出血量、住院时间、住院费用均明显低于对照组，差异具有统计学意义(t＝8.712、9.251、9.435、8.987、9.296，均为P<0.01)；两组患者术后3个月的VAS、HSS、WOMAC、SF-36评分较术前明显改善，差异具有统计学意义(观察组：t＝7.692、7.802、8.453、7.622，均为P<0.01；对照组：t＝7.639、7.787、8.441、7.619，均为P<0.01)，各评分组间比较差异均无统计学意义(t＝0.258、0.401、0.250、0.542，均为P>0.05)。 结论腓骨近端截骨术与人工全膝关节置换术治疗内侧间室膝骨关节炎，均可获得较好的早期效果；前者手术简单、创伤小、费用低，临床中可以选择性使用。

Short term effect of proximal fibular osteotomy in treatment of medial compartment knee osteoarthritis

ObjectiveTo observe and analyze the short-term effects of proximal fibular osteotomy and total knee arthroplasty in the treatment of medial compartment knee osteoarthritis. MethodsThe patients who received proximal fibular osteotomy (PFO) and total knee arthroplasty (TKA) in the orthopedics department of Chifeng Baoshan Traditional Chinese Medicine Hospital from January 2018 to December 2019 were reviewed. The patients with diagnosis of medial compartment knee osteoarthritis and Kellgren-Lawrence grade III and IV and with complete follow-up data were included. The knee intraarticular deformity and other diseases affecting joint function were excluded, and serious medical diseases and valgus deformity were excluded. 55 patients received PFO were included in the observation group and 55 patients received TKA were included in the control group. The operation time, incision length, intraoperative blood loss, length of hospital stay and hospitalization expenses of the two groups were compared by t test. Visual analogue scale (VAS)score, Hospital for special surgery(HSS) score, the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) score, short form 36 questionnaire (SF-36) score before and three months after operation were statistically analyzed, and t test was used for intra group and inter group comparison. ResultsThe operation time, incision length, intraoperative blood loss, length of stay and hospitalization expenses in the observation group were significantly lower than those in the control group (t= 8.712, 9.251, 9.435, 8.987, 9.296, all P<0.01). The VAS, HSS, WOMAC, SF-36 scores of the two groups were significantly improvedafter operation(observation group: t=7.692, 7.802, 8.453, 7 622, all P<0.01; control group: t=7.639, 7.787, 8.441, 7.619, all P<0.01), and there was no significant difference between the two groups (t=0.258, 0.401, 0.250, 0.542, all P>0.05). ConclusionsGood clinicalresults can be achieved in the early treatment of medial compartment knee arthritis by proximal fibular osteotomy and total knee arthroplasty. Because of simple, minimally invasive and low cost, PFO can be used selectively in clinic.