腓骨近端截骨联合膝关节镜清理术治疗膝骨性关节炎伴膝内翻疗效研究

Clinical Effect of Proximal Fibular Osteotomy Combined with Arthroscopic Debridement in the Treatment of Knee Osteoarthritis with Knee Varus

目的:探讨膝关节镜清理术与腓骨近端截骨术联合治疗膝骨性关节炎(KOA)伴膝内翻患者的临床效果。方法:选取本院102例KOA患者根据治疗方式分为联合组(40例)、膝关节镜清理组(单纯组,62例),联合组患者采用膝关节镜清理术结合腓骨近端截骨术治疗,单纯组仅采用膝关节镜清理术治疗,采用疼痛视觉模拟评分(VAS)评估疼痛程度,膝关节协会评分(KSS)、Lysholm评分对术前、术后1周、术后1个月、术后6个月、术后12个月膝关节功能进行评定。结果:两组手术时间、住院时间、随访时间对比差异无统计学意义(P>0.05).两组术后1周,6个月及12个月VAS评分逐渐降低,KSS和Lysholm评分逐渐升高,联合组改善程度优于单纯组,差异有统计学意义(P<0.05).联合组术后1周、6个月、12个月JS角、FT角逐渐降低,均低于术前,差异有统计学意义(P<0.05);单纯组手术前后JS角、FT角对比差异无统计学意义(P>0.05).联合组并发症发生率(10.00%)高于单纯组(4.84%),差异无统计学意义(P>0.05).结论:膝关节镜清理术与腓骨近端截骨术联合治疗能够明显缓解患者膝关节疼痛、改善膝关节功能,临床效果优于单纯膝关节镜清理。

Objective：To explore the clinical effect of arthroscopic debridement and proximal peroneal osteotomy in the treatment of knee osteoarthritis with genu varus deformity.Methods：102 KOA patients in our hospital were divided into combined group（40 cases）and knee arthroscopic debridement group（62 cases）.The patients in the combined group were treated by arthroscopic debridement combined with proximal fibular osteotomy,and the simple group was treated by arthroscopic debridement.The visual analogue scale（VAS）was used to assess the pain severity before operation,1 week,1 month,6 months and 12 months after operation,and the knee association score（KSS）and the Lysholm score were used to assess knee function.The incidence of postoperative complications was compared between the two groups.Results：There was no significant difference in operation time,length of stay and follow-up time between the two groups（P〈0.05）.The VAS score of two groups decreased gradually after 1 week,6 months and 12 months,and the scores of KSS and Lysholm increased gradually.The improvement degree of the combined group was better than that of the simple group（P〈0.05）.The JS angle and FT angle decreased gradually in the combined group at 1,6 and 12 months after operation,which were lower than those before the operation（P〈0.05）;there was no significant difference in JS angle and FT angle before and after operation in the simple group（P〈0.05）.The complication rate of the combined group（10.00%）was higher than that of the simple group（4.84%）,but the difference was not significant（P〈0.05）.Conclusion：Arthroscopic debridement combined with proximal fibular osteotomy can significantly improve the knee pain and improve the knee function of the patients,and the clinical effect is better than that of simple arthroscopic debridement.