人工全膝关节置换术与腓骨近端截骨术在内翻型膝关节骨关节炎患者中的应用效果

The Application Effect of Artificial Total Knee Replacement and Proximal Fibular Osteotomy in Patients with Varus Knee Osteoarthritis

目的对比人工全膝关节置换术与腓骨近端截骨术在内翻型膝关节骨关节炎患者中的应用效果.方法选择2015年6月—2020年5月该院收治的80例内翻型膝关节骨关节炎患者,将其随机分为两组,对照组40例行人工全膝关节置换术,研究组40例行腓骨近端截骨术.对比两组术中与术后情况,术前与术后6个月膝关节康复情况,以及术后并发症发生情况.结果研究组手术时间与住院时间均短于对照组,术中失血量少于对照组,组间差异有统计学意义(P<0.05).两组术后6个月美国纽约特种外科医院(Hospital for Special Surgery,HSS)评分与Barthel指数(Barther index,BI)评分均高于术前,差异有统计学意义(P<0.05);两组术后6个月HSS评分与BI评分对比,组间差异无统计学意义(P>0.05).研究组并发症发生率低于对照组,差异有统计学意义(P<0.05).结论人工全膝关节置换术与腓骨近端截骨术均能够促进内翻型膝关节骨关节炎患者膝关节康复,保障其日常生活能力,但采用腓骨近端截骨术治疗的患者的康复速度更快,并发症发生率更低,有效保障了患者的预后.

Objective To compare the application effects of artificial total knee replacement and proximal fibular osteotomy in patients with varus knee osteoarthritis.Methods From June 2015 to May 2020,80 patients with varus knee osteoarthritis were selected and randomly divided into two groups.40 patients in the control group underwent artificial total knee arthroplasty,and 40 patients in the study group underwent osteotomy of the proximal fibula.The intraoperative and postoperative conditions,the knee joint rehabilitation before and 6 months after the operation,and the occurrence of postoperative complications of the two groups were compared.Results The operation time and hospital stay of the study group were shorter than those of the control group,and the blood loss during the operation was less than that of the control group,and the differences between the groups were statistically significant(P<0.05).The Hospital for Special Surgery(HSS)scores and Barther index(BI)scores of the two groups at 6 months after surgery were higher than those before surgery,and the differences were statistically significant(P<0.05);there was no significant difference between the HSS score and BI score of the two groups at 6 months after operation(P>0.05).The incidence of complications in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Both artificial total knee replacement and proximal fibular osteotomy can promote the rehabilitation of knee joints in patients with varus knee osteoarthritis,and ensure their ability of daily living.However,patients treated with proximal fibular osteotomy have a faster recovery speed and a lower incidence of complications,which effectively guarantees the prognosis of patients.