单纯腓骨高位截骨术与关节冲洗清理联合腓骨高位截骨术治疗膝骨关节炎的效果

The effect of simple high fibular osteotomy and arthroscopic lavage debridement combined with high fibula osteotomy in the treatment of knee osteoarthritis

目的探讨单纯腓骨高位截骨术与关节冲洗清理联合腓骨高位截骨术治疗膝骨关节炎的短期、长期效果。方法选择2014年11月~2015年11月来我院治疗的64例膝骨关节炎患者,根据治疗方式的不同分为联合组(n=34)和单纯组(n=30),联合组采用关节冲洗清理联合腓骨高位截骨术,单纯组仅采用腓骨高位截骨术。对比两组VAS疼痛评分、AKS膝关节评分、患者满意率及并发症发生率。结果两组患者术后VAS评分较术前明显降低(P<0.05),AKS评分明显增高(P<0.05)。术后1、3个月,联合组VAS评分均较单纯组低,AKS评分较单纯组高,差异均有统计学意义(P<0.05);术后6、12个月,两组VAS评分、AKS评分比较,差异无统计学意义(P>0.05)。术后3个月,联合组患者满意率显著高于单纯组(P<0.05);但术后12个月,两组患者满意率比较,差异无统计学意义(P>0.05)。术后12个月内两组患者并发症发生率比较,差异无统计学意义(P>0.05)。结论以上两种治疗方式均能有效治疗膝骨关节炎,但联合关节冲洗对远期疗效无明显增益,且单纯腓骨高位截骨术创伤小、花费少、手术较简单,值得临床推广。

Objective To explore the effect of simple high fibular osteotomy and arthroscopic lavage debridement combined with fibula osteotomy in the treatment of knee osteoarthritis.Methods From November 2014 to November 2015,64 cases treated in our hospital were divided into joint group （n=34） and simple group （n=30） according to the different treatment.The joint group adopted arthroseopic lavage debridement combined with high fibula osteotomy,and the simple group only adopted high fibula osteotomy.VAS pain score,AKS knee scores,patients＇ satisfaction rate and complications rate between two groups were compared.Results VAS score of two groups was significantly reduced （P〈0.05）,and AKS score was significantly higher （P〈0.05） after operation than that before operation.1 month and 3 months after operation, VAS score of the joint group was lower than that of the simple group （P〈0.05）,AKS score was higher than that of the simple group（P〈0.05）.6,12 months after operation,VAS score and AKS score of two groups had no significant difference （P〉0.05）.The patients＇ satisfaction of the joint group was higher than that of the simple group 3 months after operation （P〈0.05）,but there was no significant difference of two groups 12 months after operation （P〉0.05）.The complication rate within 12 months of two groups had no significant difference （P〉0.05）.Couelusion The above two kinds of treatment methods are effective in the treatment of knee osteoarthritis,but the combination of arthroscopic lavage debridement has no obvious gain on the long-term effect, the simple high fibular osteotomy has characteristics of relatively simple trauma,less cost and simpler operation,which is worth to be promoted.