胫骨高位截骨联合外侧支持带松解治疗内翻型膝骨性关节炎合并髌骨外侧高压综合征

目的:探讨胫骨高位截骨术联合关节镜下髌骨外侧支持带松解术在内翻型膝骨性关节炎膝关节屈曲功能的临床疗效.方法:对2017年10月至2019年4月采用胫骨高位截骨联合关节镜下髌骨外侧支持带松解治疗的43例内翻型膝关节骨性关节炎合并髌骨外侧高压综合征患者进行回顾性分析,其中男15例,女28例;年龄53～72(62.05±5....

High tibial osteotomy combined with lateral retinacular release for the treatment of knee varus osteoarthritis with lateral patellar compression syndrome

Objective: To investigate the clinical effect of high tibial osteotomy combined with arthroscopic lateral retinacular release in the treatment of knee varus osteoarthritis.Methods: From October 2017 to April 2019,a retrospective analysis was performed on 43 patients with knee varus osteoarthritis and lateral patellar compression syndrome treated by high tibial osteotomy combined with arthroscopic lateral retinacular release. There were 15 males and 28 females,aged 53 to 72(62.05±5.17) years. The visual analogue scale(VAS),Lysholm,and the knee range of motion were used to evaluate knee pain and functional recovery before operation,2 weeks,3 months and 12 months after operation. And the congruence angle (CA),patellar tilt angle (PTA),and femala-tibial angle (FTA) were measured respectively before and 12 months after operation to evaluate the congruence of patellar joint,and the improvement of line of gravity of lower limb.Results: All 43 patients were followed up for more than 12 months,with a follow-up time of 14 to 28(19.60±4.50) months. The VAS scores decreased from 6.65±0.65 before operation to 2.16±0.95,0.51±0.77 and 0.33±0.64 at 2 weeks,3 months and 12 months after operation,and the difference was statistically significant (P<0.001). Lysholm score increased from 43.02±8.54 before operation to 46.84±2.81,72.42±5.30,and 93.40±5.44 at 2 weeks,3 months and 12 months after operation,and the difference was statistically significant(P<0.001). The knee range of motion increased from(86.97±5.02)° before operation to(99.38±3.27)°,(110.13±4.13)°,and (113.03±4.85)° at 2 weeks,3 months and 12 months after operation,the difference was statistically significant(P<0.001). The CA decreased from(7.81±1.21)° before operation to(5.82±4.10)° at 12 months after operation,the PTA decreased from (15.87±2.89)° before operation to(13.79±4.26)° at 12 months after operation,and the FTA decreased from(182.61±2.07)° before operation to(170.89±0.89)° at 12 months after operation,and the differences were statistically significant(P<0.05). One case received proper braking and anticoagulation after operation,and was improved after 1 week. The swelling was observed in 14 patients after operation,and subsided about 2 weeks later.Conclusion: High tibial osteotomy combined with arthroscopic lateral retinacular release can relieve weight-bearing pain in frontal axis and improve the function of knee in sagittal axis.