髌下脂肪垫包埋联合腓骨高位截骨术对膝关节骨关节炎的治疗效果研究

Clinical effect observation of “CHK” treatment combined with high peroneal osteotomy in patients with knee osteoarthritis

目的探讨髌下脂肪垫包埋(CHK)联合腓骨高位截骨术对膝关节骨关节炎的治疗效果。方法对2013年2月至2017年2月获嘉县红十字医院收治的63例膝关节骨关节炎患者的临床资料进行回顾性分析,根据患者手术方式分为对照组(n=31)和观察组(n=32),对照组患者接受单纯腓骨高位截骨术治疗,观察组患者接受CHK联合腓骨高位截骨术治疗。比较两组患者术前及术后随访3、6、9个月VAS及AKS膝关节评分。结果手术前两组患者VAS及AKS评分比较,差异无统计学意义(P>0.05);术后3、6、9个月观察组患者VAS评分均较对照组低[(4.13±0.76)分比(4.15±0.78)分,(3.39±0.54)分比(4.18±0.78)分,(3.41±0.65)分比(4.43±0.69)分],AKS评分均较对照组高[(126.24±14.24)分比(107.40±21.53)分,(125.18±15.19)分比(105.33±22.23)分,(128.59±15.53)分比(104.26±22.81)分],差异有统计学意义(P均<0.05)。结论 CHK联合腓骨高位截骨术治疗膝关节骨关节炎短、长期效果均优于单纯腓骨高位截骨术,能够延长全膝关节或单髁置换年限,且手术难度及患者治疗费用均较低,适合在基层医院推广。

Objective To analyze the clinical effect observation of ＂CHK＂ treatment combined with fibula bone cutting high curative in patients with knee osteoarthritis. Methods Sixty three patients with knee osteoarthritis who were treated in the Huo- jiaxian Red Cross Hospital from February of 2013 to February of 2017 were enrolled in this retrospective study. All patients were divided into two groups by surgical methods. Thirty one cases in control group, and 32 cases in observation group. Patients in the control group were treated with fibula bone cutting high curative, and patients in the observation group were treated with ＂CHK＂ treatment on the basis of control group. The clinical effects were compared between observation group and control group. Results The VAS and AKS score before operation between the two groups showed no significant difference （ P 〉 0. 05 ）. Compared with the control group, the observation group had statistically significant lower VAS score [ （4. 13 ± 0. 76 ） points vs （4. 15±0. 78） points, （3.39±0. 54） points vs （4. 18 ±0. 78） points, （3.41 ±0. 65） points vs （4. 43 ±0. 69） points, P 〈 0. 05 ], and higher AKS score （ 126. 24 ± 14. 24 ） points vs （ 107.40 ± 21.53 ） points, （ 125.18 ± 15.19 ） points vs （ 105.33 ± 22. 23） points, （128. 59 ±15.53） points vs （104.26±22.81） points, P 〈0.05]at 3, 6, and 9 months after surgery. Conclusion The short - term and long - term effect of CHK combined with fibula bone cutting high curative are better than fibula bone cutting high curative alone, and the time of total knee and unieondylar knee arthroplasty of patients with knee osteoar- thritis can be prolonged by CHK combined with fibula bone cutting high curative, whose operation diffieuhy is lower and treatment cost is less and worthy of popularization and application in grass roots hospitals.