膝关节镜清理联合腓骨近端截骨治疗中老年膝关节骨性关节炎的效果

Effect of knee arthroscopic debridement combined with proximal fibula osteotomy on middle and elderly patients with knee osteoarthritis

目的探讨膝关节镜清理联合腓骨近端截骨治疗中老年膝关节骨性关节炎的效果。方法选取我院2016年1月至2018年3月收治的80例老年膝关节骨性关节炎患者,根据其入院顺序分为观察组(40例,膝关节镜清理联合腓骨近端截骨)和对照组(40例,膝关节镜清理)。比较两组手术前、后WOMAC、VAS评分、MPTA、FTA角度及血清NO,MMP-9水平。结果术后,两组WOMAC、VAS评分均下降,且观察组显著低于对照组(P<0.05);两组MPTA角度均增加、FTA角度均下降,且观察组均优于对照组(P<0.05);两组血清NO、MMP-9水平均下降,且观察组显著低于对照组(P<0.05)。结论膝关节镜清理联合腓骨近端截骨可明显改善中老年膝关节骨性关节炎患者膝关节功能,缓解疼痛,其机制可能与降低NO、MMP-9水平有关。

Objective To explore the effect of knee arthroscopic debridement combined with proximal fibula osteotomy on middle and elderly patients with knee osteoarthritis.Methods A total of 80 middle and elderly patients with knee osteoarthritis were selected and divided into observation group (n=40,knee arthroscopic debridement combined with proximal fibula osteotomy) and control group (n=40,knee arthroscopic debridement) according to the order of admission.The scores of WOMAC,VAS,the angle of MPTA,FTA and the serum levels of NO,MMP-9 before and after surgery were compared between the two groups.Results After surgery,the scores of WOMAC,VAS of both groups decreased,and those of the observation group were significantly lower than the control group (P<0.05);the MPTA angle increased and the FTA angle decreased in both groups,and those of the observation group were superior to the control group (P<0.05);the levels of serum NO,MMP-9 decreased in the two groups,and those of the observation group were significantly lower than the control group (P<0.05).Conclusion Knee arthroscopic debridement combined with proximal fibular osteotomy significantly improves the knee function and relieves pain in middle and elderly patients with knee osteoarthritis,and its mechanism may be related to the reduction of NO and MMP-9 levels.