胫骨高位截骨与腓骨近端截骨治疗膝骨关节炎伴膝内翻畸形的近远期疗效比较

Comparison of the near-term and long-term efficacy of high tibial osteotomy and proximal fibula osteotomy in knee osteoarthritis with varus deformity

目的探究膝骨关节炎伴膝内翻畸形患者采取胫骨高位截骨与腓骨近端截骨治疗的临床价值。方法选择我院2016年2月至2017年8月收治的88例膝骨关节炎伴膝内翻畸形患者,按照随机数字法分为A组与B组,各44例。A组采取腓骨近端截骨,B组采取胫骨高位截骨,比较两组的治疗效果。结果术后3个月,A组患者的VAS评分显著低于B组,KSS评分显著高于B组(P<0.05);两组患者术后8个月的VAS、KSS评分无显著差异(P>0.05);与B组比较,A组患者的手术时间、住院时间更短,术中出血量更少(P<0.05)。结论胫骨高位截骨与腓骨近端截骨在膝骨关节炎伴膝内翻畸形患者治疗中均具有一定意义,远期疗效相当,但腓骨近端截骨近期效果显著,可快速减轻疼痛,改善膝关节活动能力,缩短治疗时间。

Objective To explore the clinical value of high tibial osteotomy and proximal fibula osteotomy in patientswith knee osteoarthritis and varus deformity. Methods Eighty-eight patients with knee osteoarthritis and varus deformitytreated in our hospital from February 2016 to August 2017 were selected and divided into group A and groupBaccording to the random number method, with 44 cases in each group. The group A was given proximal fibula osteotomyand the group B was given high tibial osteotomy. The clinical efficacies of the two groups were compared. Results At3months after operation, the VAS score in the group A was significantly lower than that in the group B, and the KSS scorewas significantly higher than that in the groupB （P〈0.05）. There were no significant differences in VAS and KSS scoresbetween the two groups at 8 months after operation （P〉0.05）. Compared with the group B, the group A had shorteroperative time, shorter hospital stay and less intraoperative blood loss （P〈0.05）. Conclusion High tibial osteotomy andproximal fibula osteotomy have certain significance in the treatment of knee osteoarthritis with varus deformity, the long-term efficacies are similar, but the proximal fibula osteotomy has significant near-term efficacy, can quickly reduce pain,improve knee mobility, shorten treatment time.