腓骨截骨术与全膝关节置换术治疗膝关节骨性关节炎的短期疗效分析

Short Term Effect of Fibula Osteotomy and Total Knee Arthroplasty in the Treatment of Osteoarthritis of the Knee

目的分析腓骨截骨术与全膝关节置换术治疗膝关节骨性关节炎的短期疗效。方法方便选取2014年2月—2017年2月医院收治采用腓骨截骨术(n=36)、全膝关节置换术(n=25)治疗膝骨关节炎61例,分别入组截骨组、置换组。对比疼痛、切口愈合、住院时间、并发症发生情况,与出院前HSS评分。结果截骨组术后次日VAS评分(2.95±1.21)分与置换组(2.85±1.43)分,差异无统计学意义(P>0.05),截骨组切口愈合时间、住院时间、术后并发症发生率分别为(4.3±1.5)d、(7.4±1.3)d、16.7%低于置换组(10.3±2.6)d、(16.7±4.5)d、76.0%,置换组出院前HSS评分功能评分、总分、扣分分别为(11.8±2.1)分、(73.9±3.0)分、(-0.7±0.5)分,高于截骨组(9.4±2.9)分、(68.7±3.2)分、(-1.2±1.5)分,差异有统计学意义(P<0.05)。结论腓骨截骨术与全膝关节置换术治疗膝关节骨性关节炎各有优劣,截骨术创伤小,但对关节功能恢复效果不如置换术。

Objective This paper tries to analyze the short-term curative effect of fibular osteotomy and total knee arthroplasty in the treatment of knee osteoarthritis.Methods From February 2014 to February 2017,admitted to the hospital with fibular osteotomy(n=36),total knee arthroplasty(n=25)treatment of 61 cases of knee osteoarthritis were convenient selected in the osteotomy group and permutation group.Comparison of pain,wound healing,hospitalization time,complications,and HSS score before discharge.Results There was no significant difference in the VAS score(2.95±1.21)points between the osteotomy group and the replacement group(2.85±1.43)points(P>0.05),and the incision healing time,hospitalization time and postoperative complications The rates were(4.3±1.5)d,(7.4±1.3)d,16.7%lower than those in the replacement group(10.3±2.6)d and(16.7±4.5)d,76.0%;HSS score before discharge function score,total score,respectively,points of the permutation group were(11.8±2.1)points,(73.9±3.0)points and(-0.7±0.5)points respectively,higher than that of osteotomy group(9.4±2.9)points,(68.7±3.2)points and(-1.2±1.5)points respectively,the difference was statistically significant(P<0.05).Conclusion Fibular osteotomy and total knee arthroplasty for the treatment of knee osteoarthritis have their own advantages and disadvantages,less osteotomy trauma,but less effective in the restoration of joint function replacement surgery.