摘要
目的对比内侧开放(OWHTO)与外侧闭合(CWHTO)胫骨高位截骨治疗膝关节内侧间室骨性关节的临床疗效。方法回顾性分析2014年1月至2018年12月收治的膝关节内侧间室骨性关节炎患者48例,其中采用OWHTO术式25例,采用CWHTO术式23例。术后定期随访,测量髋膝踝角(HKA)及胫骨近端内侧角(MPTA),采用疼痛视觉模拟评分(VAS)和膝关节HSS评分评估疼痛和膝关节功能。结果 OWHTO组和CWHTO组术前MPTA角度、HKA角度、HSS评分和VAS评分对比差异无统计学意义(P> 0.05);末次随访时,OWHTO组和CWHTO组MPTA角度分别为(90.47±1.15)°、(90.95±1.18)°,HKA角度分别为(180.25±1.55)°、(180.91±2.03)°,组间差异无统计学意义(P> 0.05),但分别与术前对比,差异有统计学意义(P <0.05);末次随访时,OWHTO组和CWHTO组HSS评分别为(84.60±2.29)、(85.30±1.55)分,组间差异无统计学意义(P> 0.05),但与术前对比,差异有统计学意义(P <0.05)。结论 OWHTO和CWHTO术式对于膝关节内侧间室骨关节炎具有良好的临床疗效,两种术式的早期疗效未见明显差异。
Objective To compare the clinical efficacy of medial opening-wedge with lateral closed-wedge high tibial osteotomy for medial compartment osteoarthrosis of the knee.Methods A retrospective analysis was performed on 48 patients with medial compartment osteoarthritis of the knee treated from January 2014 to December 2018,including 25 receiving OWHTO and 23 receiving CWHTO.The hip,knee and ankle angles(HKA) and proximal medial tibia angles(MPTA) were measured during regular postoperative follow-up,and pain and knee function were assessed by visual analogue scale(VAS) and knee HSS scores.Results There were no statistical significant differences in preoperative MPTA,HKA,HSS and VAS scores between OWHTO and CWHTO groups(P> 0.05).At the last follow-up,the MPTA angle was(90.47±1.15)° in OWHTO group and(90.95±1.18)° in CWHTO group,and the HKA angle was(180.25±1.55)° and(180.91±2.03)°,respectively.There were no statistical significances between the groups(P> 0.05),but there were significant differences from the preoperative comparison(P<0.05).At the last follow-up,the HSS score was(84.60±2.29) points in OWHTO group and(85.30±1.55) points in CWHTO group.There was no statistical significance(P> 0.05) between the two groups,but as compared with that before surgery,there was significant difference(P <0.05).Conclusions OWHTO and CWHTO have a better clinical efficacy for medial compartment osteoarthritis of the knee,and there is no significant difference in the early efficacy between the two procedures.
作者
沈高波
崔龙慷
方源
李学飞
李振
吴连国
SHEN Gaobo;CUI Longkang;FANG Yuan;LI Xue-fei;LI Zhen;WU Lianguo(The Second Clinical Medical College of Zhejiang Chinese Medicine University,Hangzhou 310053,China;不详)
出处
《实用医学杂志》
CAS
北大核心
2021年第8期1031-1036,共6页
The Journal of Practical Medicine
基金
浙江省“十三五”中医药重点专科项目(编号:浙卫办中医[2019]1号)
2017年浙江省高校中青年学科带头人培养对象项目(编号:浙教办高科[2017]68号)
国家中医临床研究基地支撑学科建设计划(编号:2020-JDXK-ZC01)。
关键词
胫骨高位截骨
内侧开放截骨
外侧闭合截骨
骨性关节炎
high tibial osteotomy
medial opening-wedge osteotomy
lateral closed-wedge osteotomy
osteoarthritis