膝关节软骨剥脱分期对腓骨近端截骨治疗膝关节骨关节炎的指导意义

Guiding significance of the osteochondritis dissecans stages in the treatment of knee osteoarthritis with proximal fibular osteotomy

膝关节骨关节炎(knee osteoarthritis,KOA)是导致老年患者膝关节功能丧失的主要原因,进行性疼痛与活动障碍极大地影响了老年患者的生活质量,然而对于其发展机制的研究尚无确定性理论。"不均匀沉降"理论从关节不均匀退变的角度阐述了膝关节KOA常伴内翻畸形的发生机制,指出胫骨平台密度退变快于腓骨是导致膝关节内翻的主要原因,在此理论基础上开展的腓骨近端截骨术通过临床实践获得了良好的效果。本文提出膝关节软骨剥脱分期对于腓骨截骨术治疗KOA的指导意义,为此新术式手术适应证的界定提供参考。

Knee osteoarthritis （KOA） is a main reason leading to the loss of knee joint function in elderly patients. Gradually increased pain and movement disorder greatly influence the patients＇ life quality. However, the mechanism behind this disease is still unknown nowadays. The theory of ＂non- uniform settlement＂ elaborates the possible mechanism of the KOA with varus deformity, pointing out that the tibial plateau density degenerates faster than that of the fibula, which results in the knee varus deformity. Based on this new theory, proximal fibular osteotomy is performed to treat KOA with varus deformity and has obtained satisfactory clinical effect. In this paper, the author emphasized the significance of osteochondritis dissecans stages in the treatment of knee osteoarthritis with proximal fibular osteotomy and provided clinical indications for the application of this new surgical method.