关节镜并胫骨高位截骨术治疗伴内翻畸形膝关节单间室骨关节炎

Treatment of unicompartmental knee osteoarthritis with varus by high tibial osteotomy combined with arthriscopic debridement

[目的]探讨膝关节镜并内侧开放式胫骨高位截骨术治疗膝关节单间室骨性关节炎的临床疗效。[方法]自2004年4月~2009年12月在本院行膝关节镜并内侧开放式胫骨高位截骨术患者46例（64膝）,平均随访32.4个月,分别测量患者膝关节术前及术后的股胫角,并对患者膝关节进行HSS评分。[结果]所有患者术后股胫角术前平均内翻-4.44°±1.18°矫正到术后平均外翻8.37°±1.10°（P〈0.001）。HSS评分由术前的（54.25±5.40）分提高到术后的平均（89.67±3.38）分（P〈0.001）。[结论]膝关节镜并内侧开放式胫骨高位截骨术是治疗轻中度膝关节单间室骨性关节炎的有效手术方法,近中期疗效满意。

[Objective]This study examines the treatment of unicompartmental osteoarthritis of the knee and the clinical efficacy using the medial opening wedge high tibial osteotomy（HTO）. [Methods]Since April 2004-December 2009 in our hospital 46 patients（64 knees） underwent medial arthroscopy-assisted opening wedge high tibial osteotomy（HTO）.And all the patiens allowed a follow-up visit.After surgery the average follow-up visit time was 32.4 months.After respectively observing the varus angle of the knee,before and after the surgery,doctors began HSS scoring.[Results]All 46 patients＇ incision（64 knees） healed in the first stage.The femoro-tibial angle had a mean varus of-4.44±1.18° preoperatively.This was corrected to a mean valgus of 8.37±1.10° at the final follow-up（P0.001）.The average preoperative HSS score was（54.25±5.40）,whereas the postoperative score was evaluated as（89.67±3.38） at the final follow-up（P0.001）.[Conclusion]Medial opening wedge HTO has been considered as a classic option in the surgical management for unicompartment knee osteoarthritis.Effect in recent and mid-term is satisfactory.