成人膝大骨节病的手术治疗

Surgical treatment on the adult Kaschin-Beck disease

目的探讨手术治疗成人膝大骨节病的疗效。方法对222例成人膝大骨节病患者根据病情程度，选择关节镜下有限清理加钻孔减压术、关节镜下有限清理加截骨、切开关节清理或合并截骨、人工关节置换术。结果本组222例术后随访1．5～5年，术后均无严重疼痛，功能障碍及假体松动、下沉、倾斜、脱位，无下肢深静脉血栓形成，无肺栓塞、腓总神经压迫损伤及关节不稳等并发症。有2例关节血肿，经关节抽液后消失，1例浅表感染，经关节冲洗后痊愈。按Hss关节评分等级评价优良率为72％。结论根据病情程度选择手术治疗成人膝大骨节病，可以缓解关节疼痛，改善关节功能，近期疗效较满意。

Objective To observe the surgical effect on the treatment of adult KBD patients. Methods 222 cases of adult patients with Kashin-Beek client were followed up. The treatment selection included limited arthroscopic decompression bored add clean-up, limited arthroscopic clean-up add osteotomy, open joints clean-up or merger of osteotomy, artificial joint replacement. Results 222 postoperative cases were followed-up for 1.5 -5 years. No severe postoperative pain, dysfunction and prosthetic loosening, subsidence, tilt, dislocation, no deep venous thrombosis without pulmonary embolism, common peroneal nerve compression injury or complications such as joint instability were occurred. Articular hematoma happened in two cases, after aspiration of joint fluid the symptom was disappeared. One case had superficial infection and recovered by the joint irrigation. The motor function of hip was evaluated by Harr hip score, excellent and good rate was 72%. Conclusions Surgical treatment of adult Kashin-Beck disease according to the different severity of disease, which can alleviate the joint ache and improve joint movable function, and gives good and excellent outcomes.