腓骨近端截骨与关节镜下清理治疗中老年膝关节骨关节炎

Proximal fibula osteotomy and arthroscopic debridement in the treatment of knee osteoarthritis in the middle-aged and elderly

目的探讨腓骨近端截骨与关节镜下清理治疗中老年膝关节骨关节炎的临床效果。方法将90例膝关节骨关节炎患者按照治疗方法的不同分为对照组(采用全膝关节置换术治疗,45例)与观察组(采用腓骨近端截骨与关节镜下清理治疗,45例)。记录两组住院时间、治疗费用、并发症发生情况。术后6个月采用HSS评分、疼痛VAS评分、膝关节活动度评价临床疗效。结果患者均获得随访,时间6~12个月。住院时间、治疗费用观察组明显短(少)于对照组(P<0.01)。术后6个月两组HSS评分、VAS评分、膝关节活动度均明显优于术前(P<0.05),3项指标两组间比较差异均无统计学意义(P>0.05)。两组均无切口感染、神经损伤、关节粘连等并发症发生。结论采用腓骨近端截骨与关节镜下清理治疗中老年膝关节骨关节炎能快速缓解患者疼痛,恢复膝关节活动,且并发症少、住院时间短、治疗费用低,临床疗效满意。

Objective To investigate the clinical effect of proximal fibula osteotomy and arthroscopic debridement in the treatment of knee osteoarthritis in the middle-aged and elderly patients.Methods According to the treatment method,the 90 patients with knee osteoarthritis were divided into control group(45 patients were treated with total knee arthroplasty)and observation group(45 patients were treated with proximal fibula osteotomy and arthroscopic debridement).The hospitalization time,treatment cost and complications situation in the two groups were recorded.At 6 months postoperation,HSS score,VAS and range of motion(ROM)of knee joint were used to evaluate the clinical effect.Results The patients were followed up for 6~12 months.The hospitalization time and treatment cost of the observation group were significantly shorter(less)than those of the control group(P<0.01).At 6 months after operation,HSS score,VAS and ROM of knee joint were significantly better than the preoperation(P<0.05),but there were no significant differences in various indicators of three items between the two groups(P>0.05).No incision infection,nerve injury,joint adhesion and other complications occurred in both groups.Conclusions Proximal fibula osteotomy and arthroscopic debridement in the treatment of knee osteoarthritis in the middle-aged and elderly can quickly relieve the pain of patients,restore knee joint activity,with fewer complications,shorter hospitalization time,lower treatment cost,and satisfactory clinical effect.