内侧张开胫骨高位截骨治疗膝关节内侧间室骨关节炎中期随访研究

The midterm follow-up results of medial opening-wedge high tibial osteotomy for medial compartment osteoarthritis in the knee

目的探讨内侧张开胫骨高位截骨治疗膝关节内侧间室骨关节炎的中期疗效。方法回顾性分析2007年至2010年行内侧张开胫骨高位截骨术且术中使用羟基磷灰石植骨的31例膝关节内侧间室骨关节炎患者资料,男13例,女18例,平均年龄(60.8±10.7)岁(36~75岁)。采用美国特种外科医院(HSS)膝关节评分、股骨机械轴与胫骨机械轴夹角(HKA)、胫骨近端内侧角(MPTA)、疼痛视觉模拟评分(VAS)及手术并发症发生情况等评估中期疗效。结果术前与末次随访时HSS膝关节评分分别为(68±11)分、(88±11)分,两者有明显差异(P<0.05)。术前与末次随访时MPTA分别为84.8°±3.1°、95.3°±4.9°,两者有明显差异(P<0.05)。术后1年与末次随访时MPTA和HSS膝关节评分均无明显差异(分别为P=0.28和P=0.24)。结论内侧张开胫骨高位截骨治疗膝关节内侧间室骨关节炎可以获得满意的中期疗效。

Objective To investigate the midterm outcome of the medial opening-wedge high tibial osteotomy for medial compartment osteoarthritis in the knee.Methods From 2007 to 2010,31patients（13 males and 18females）were diagnosed as medial compartment osteoarthritis of the knee joints,and received medial opening-wedge high tibial osteotomy with hydroxyapatite bone graft.The average age of patients was（60.8±10.7）years（range,36-75years）.Clinical outcome was evaluated with Hospital for Special Surgery score（HSS score）,Hip Knee Angle（HKA）,Medial Proximal Tibia Angle（MPTA）,Visual Analogue Scale（VAS）and the number of complications.Results Preoperatively,the mean HSS score and MPTA were（68±11）points and 84.8°±3.1°,respectively.At the last follow-up,the mean HSS score and MPTA were（88±11）points and 95.3°±4.9°,respectively.All clinical scores showed a significant improvement after operation.However,no significance difference was found between the HSS score or MTPA at one year after surgery and that at the last time follow-up.Conclusion Opening-wedge high tibial osteotomy achieved satisfactory mid-term results in the treatment for medial compartment osteoarthritis.