关节镜下内固定关节融合术对晚期踝关节炎患者的疗效及AOFAS和VAS评分的影响

Effect of arthroscopic internal fixation and fusion for the treatment of patients with advanced ankle arthritis and the influence of AOFAS and VAS score

目的探讨关节镜下内固定关节融合术对晚期踝关节炎患者的疗效及美国矫形足踝协会评分系统(AOFAS)和疼痛视觉模拟评分(VAS)的影响。方法选取该院2012年1月-2015年1月收治的晚期踝关节炎患者84例,采用前瞻性研究的方法将研究对象随机分为实验组(42例)及对照组(42例),对照组患者采用传统开放性踝关节融合术,实验组在关节镜辅助下行内固定关节融合术。比较患者手术时间、术中出血量、术后住院时间和并发症发生率,同时随访12~36个月,采用AOFAS评分系统评估疗效,采用VAS评估患者踝关节疼痛程度。结果实验组的手术时间、术中出血量明显少于对照组(P<0.05);两组患者术后情况对比,实验组术后住院时间及关节融合时间均少于对照组(P<0.05);随访1年结果显示:实验组VAS及AOFAS评分均优于对照组(P<0.05),实验组并发症发生率(9.52%)明显低于对照组(28.57%)(P<0.05)。结论关节镜下内固定关节融合术手术时间短、术中出血量少、并发症发生率低,术后愈合率高,远期随访疗效确切,适合在临床推广使用。

Objective To study the effect of arthroscopic internal fixation combined with arthrodesis on patients with advanced ankle arthritis and American Orthopedic Ankle Association Scoring System(AOFAS)and visual analogue scale(VAS).Methods84patients with advanced ankle arthritis from January2012to January2015were randomly divided into experimental group(42cases)and control group(42cases)by random number method.The patients in the control group were treated with traditional open ankle arthrodesis,the experimental group under the arthroscopic assisted internal fixation joint fusion.Then compare the time of surgery,intraoperative blood loss,postoperative hospitalization time and complication.The follow-up period was12to36months.Used the AOFAS score system to evaluate the curative effect.Use VAS to evaluate the degree of ankle pain.Results The operation time and intraoperative blood loss were significantly lower in the experimental group than that in the control group(P<0.05).The postoperative hospital stay and the time of joint fusion were lower in the experimental group than that in the control group(P<0.05).The incidence of complication(9.52%)in the experimental group was significantly lower than that in the control group(25.57%)(P<0.05).The results of follow-up showed that the VAS and AOFAS scores of the experimental group were better than those in the control group(P<0.05).Conclusion The procedure of arthroscopic endoscopic fusion is short,the bleeding rate is low,the incidence of complications is low,the healing rate is high,and the follow-up effect is accurate.It is suitable for clinical use.