关节镜辅助下踝关节融合术的临床应用与体会

Clinical application and experience of arthroscopic ankle arthrodesis

目的:探讨关节镜辅助下踝关节融合术的临床疗效。方法:2011年3月至2015年7月对19例踝关节晚期病变患者行关节镜辅助下踝关节融合术。其中男11例,女8例;年龄48~75岁,平均65.3岁。左侧12例,右侧7例;踝关节重度骨关节炎4例,踝关节创伤性关节炎15例。所有患者术前均进行踝关节磁共振检查,以评估踝关节软骨的情况。记录术前和术后1年的疼痛评分,评价临床疗效。结果:所有患者获得24~36个月的随访,未出现切口愈合不良和感染的早期并发症。患者(12±1)周可获得骨性融合。术前疼痛评分为(7.8±1.3)分,术后1年为(2.1±0.9)分,差异具有统计学意义(P<0.05)。结论:关节镜辅助下行踝关节融合术,手术疗效确切,具有手术创伤小、切口美观、融合率高等优势,值得临床推广应用。

Objective：To investigate the approach and clinical results of arthroscopic ankle arthrodesis.Methods：From March 2011 and July 2015,19 patients（11 men and 8 women） underwent arthroscopic ankle arthrodesis.Mean age at surgery was 65.3 years（48-75 years）.12 cases were on the left side,7 cases were on the right side.4 cases were of severe osteoarthritis,15 post-traumatic osteoarthritis.All the patients underwent preoperative ankle magnetic resonance imaging（MRI） to assess the damage of ankle cartilage.Clinical outcome were assessed according to pre-and postoperative pain scores 1 year after surgery.Results：All the patients completed 24-36 months follow-up.There were no peri-operative complications such as poor healing of incision or infection.The average time for fusion was（12±1） weeks,with a range of 10 to 15 weeks.Preoperative pain scores（7.8±1.3）,postoperative pain scores 1 year after surgery（2.1±0.9）.The difference was statistically significant.Conclusion：In our study,arthroscopic ankle arthrodesis has resulted in good functional outcome with minimum and cosmetic incisions and a high fusion fate,worthy of clinical popularization and application.