腓骨近端截骨术与全膝关节置换术治疗内翻型膝关节骨关节炎患者的对比研究

Comparative Study of Proximal Peroneal Osteotomy and Total Knee Arthroplasty in the Treatment of Patients with Osteoarthritis of the Knee Joint

目的:对比腓骨近端截骨术、全膝关节置换术(TKA)两种术式治疗内翻型膝关节骨关节炎患者的效果。方法:选择2016年2月-2017年2月期间我院收治的98例(98膝)内翻型膝关节骨关节炎患者,以随机数表法分为对照组与研究组,每组各49例(49膝)。研究组给予腓骨近端截骨术治疗,对照组给予TKA治疗,比较两组患者手术时间、术中失血量、住院时间、术后并发症情况,比较术前与术后1年膝关节功能、膝部疼痛程度、关节活动度、内翻角、生活质量的变化情况。结果:研究组手术时间、术中失血量、住院时间均低于对照组(P<0.05)。两组术后并发症发生情况对比无统计学差异(P>0.05)。术后1年两组患者美国特种外科医院(HSS)膝关节评分、关节活动度高于术前,视觉疼痛模拟(VAS)评分、内翻角低于术前(P<0.05),但两组间对比无统计学差异(P>0.05)。术后1年两组患者生理职能、生理机能、社会功能、活力、躯体疼痛、情感职能、精神健康与总体健康评分均高于术前,且研究组各项评分高于对照组(P<0.05)。结论:与TKA术式比较,腓骨近端截骨术治疗内翻型膝关节骨关节炎患者在手术时间、术中失血量、住院时间等临床指标中均占有优势,可显著改善患者的生活质量,且无严重并发症发生。

Objective: To compare the effect of proximal peroneal osteotomy and total knee arthroplasty(TKA) in the treatment of patients with osteoarthritis of the knee joint. Methods: 98 cases(98 knees) of patients with osteoarthritis of the knee joint who were treated in our hospital from February 2016 to February 2017 were selected, the patients were divided into control group and study group according to the random number table method, 49 cases(49 knees) in each group. The study group was treated with proximal peroneal osteotomy,the control group was treated with TKA, the operation time, blood loss, hospitalization time and postoperative complications of the two groups were compared, the changes of knee function, knee pain, joint activity, varus angle and quality of life were compared between before operation and 1 year after operation. Results: The operation time, the amount of blood loss and hospitalization time in the study group were all lower than those of the control group(P<0.05). There was no statistically significant difference in the incidence of postoperative complications between the two groups(P>0.05). 1 year after operation, knee joint score of American Special Surgery Hospital(HSS), joint activity,visual pain simulation(VAS) score, inversion angle in the two groups were lower than those before operation(P<0.05), but there was no statistical difference between the two groups(P>0.05). 1 year after operation, the scores of physiological function,Physiologi enginery, social function, vitality, somatic pain, emotional function, mental health and general health of the two groups were all higher than those before operation and the scores in the study group were higher than those in the control group(P<0.05). Conclusion:Comparison of the TKA, the proximal peroneal osteotomy is superior to the patients with varus knee osteoarthritis in the operation time,the amount of blood loss and the time of hospitalization, it can significantly improve the quality of life of patients, and no serious complications occur.