关节镜清理+胫骨高位截骨内固定治疗青年膝内翻型骨关节炎

High level tibial osteotomy combined with arthroscopic therapy for the treatment of varus knee with osteoarthritis in youth

目的评价应用关节镜清理+胫骨高位截骨钢板内固定治疗青年膝内翻型骨关节炎的临床疗效。方法26例36膝青年性膝内翻患者行关节镜清理+胫骨高位截骨钢板内固定术。年龄18～35岁,平均29.5岁。术后观察X线及临床症状的变化。结果24例33膝获随访,随访时间1.0～4.5年,平均3.2年,截骨部位临床愈合时间为8～12周,平均10周,无一例不愈合,术后X线片示膝关节内侧间隙明显增宽,膝关节内翻畸形基本纠正,优良率为90.9%。结论关节镜清理+胫骨高位截骨钢板内固定具有手术创伤小、固定牢固、早期功能锻炼、术后恢复快等优点,是治疗青年膝内翻型骨关节炎患者的一种较好方法。

Objective To study the clinical effect of High level tibial osteotomy combined with arthroscopic therapy for the treatment of varus knee with osteoarthritis in youth. Methods Twenty-six （36 knees） patients underwent HTO with arthroscopic cleaning. X-rays and clinical symptoms were observed pre and postoperatively. Results Thirty-three knees （24 patients） were followed-up for 3.2 years （range 1-4.5 years）. The mean time of bone union was 10 weeks （range 8 to 12 weeks） without non-union cases. Postoperative X-ray showed the media space was widened significantly. The varus angle of the knee was corrected generally. The excellent and good rate was 90.9%. Conclusions The advantages of HTO combined with internal fixation with plate and arthroscopic cleaning are less invasive, stabilized with early exercise permitting and quick recovery. It is a sound method for intra varus osteoarthritis knee in youth.