膝关节周围截骨术治疗膝关节骨关节炎的临床效果

Clinical effect of osteotomy around knee joint in treatment of knee osteoarthritis

目的探讨膝关节周围截骨术治疗膝关节骨关节炎的临床效果。方法选取2018年1月—2020年5月牡丹江医学院附属红旗医院收治的60例膝关节骨关节炎患者作为研究对象,按照随机信封法将其分为对照组(30例)与观察组(30例)。对照组患者采用全膝关节置换术,观察组患者采用膝关节周围截骨术。比较两组患者的手术基本情况、股胫角(FTA)、髋-膝-踝角(HKA)及手术前后疼痛度。结果观察组的手术时间、住院时间短于对照组,术中出血量少对照组,差异有统计学意义(P<0.05)。两组术后6周和术后3、6个月的FTA、HKA低于术前,差异有统计学意义(P<0.05),观察组的FTA、HKA低于对照组,差异有统计学意义(P<0.05)。两组术后6周和术后3、6个月的视觉模拟评分法(VAS)评分低于术前,差异有统计学意义(P<0.05)。观察组的VAS评分低于对照组,差异有统计学意义(P<0.05)。结论膝关节周围截骨术治疗膝关节骨关节炎疗效显著,可一定程度替代全膝关节置换术,保留原有的膝关节结构。

Objective To analyze the clinical effect of osteotomy around the knee joint in the treatment of knee osteoarthritis.Methods From January 2018 to May 2020,60 patients with knee osteoarthritis admitted to the Hongqi Hospital of Mudanjiang Medical College were selected as the research objects.According to the random envelope method,they were divided into the control group(30 cases)and the observation group(30 cases).The control group received total knee arthroplasty,and the observation group received osteotomy around the knee joint.The basic operation conditions,femoral tibial angle(FTA),hip-knee-ankle angle(HKA),and preoperative and postoperative pain levels of the two groups were compared.Results The operation time and hospital stay of the observation group were shorter than those of the control group,and the intraoperative blood loss was less in the control group,the differences were statistically significant(P<0.05).The FTA and HKA of the two groups at 6 weeks,3 months and 6 months after operation were lower than those before operation,and the differences were statistically significant(P<0.05).The FTA and HKA of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).The visual analogue scale(VAS)scores of the two groups at 6 weeks,3 months,and 6 months after operation were lower than those before operation,and the differences were statistically significant(P<0.05).The VAS score of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Peripheral knee osteotomy is effective in treating knee osteoarthritis.It can replace total knee arthroplasty to a certain extent and retain the original knee joint structure.