腓骨截骨术联合关节镜下膝关节清理术治疗膝骨性关节炎的临床效果

Clinical Effect of Proximal Fibular Osteotomy Combined with Arthroscopic Debridement on Knee Osteoarthritis

目的探讨腓骨截骨术联合关节镜下膝关节清理术治疗膝骨性关节炎(KOA)的临床效果。方法选取鹤壁市人民医院2016年10月至2019年10月收治的KOA患者93例,按随机数字表法分为2组:对照组46例行关节镜下膝关节清理术,观察组47例行腓骨截骨术联合关节镜下膝关节清理术,观察2组疼痛程度[视觉疼痛模拟(VAS)评分],膝关节功能(股骨胫骨角、胫骨关节间隙角、膝关节活动度)以及不良情绪[焦虑自评量表(SAS)评分和抑郁自评量表(SDS)评分]。结果与对照组比较,观察组治疗后VAS评分显著升高,股骨胫骨角显著增大、胫骨关节间隙角显著减小、膝关节活动度显著增大,SAS、SDS评分均显著降低,差异有统计学意义(均P<0.05)。结论腓骨截骨术联合关节镜下膝关节清理术治疗KOA效果确切,通过减轻腓骨重力以及增强周边软组织重建等途径,有效地提高临床疗效、缓解疼痛程度及其对膝关节功能的影响。

Objective To investigate the clinical effect of proximal fibular osteotomy(PFO)combined with arthroscopic debridement on knee osteoarthritis(KOA).Methods A total of 93 patients with KOA admitted to Hebi People’s Hospital from October 2016 to October 2019 were randomly treated with arthroscopic debridement alone(control group,46 patients)or in combination with PFO(observation group,47 patients).The degree of pain was evaluated using the Visual Analogue Scale(VAS).Knee joint function was assessed by femorotibial angle,tibial joint space angle and knee range of motion.Negative emotions were measured using the Self-Rating Anxiety Scale(SAS)and the Self-Rating Depression Scale(SDS).Results Compared with the control group,the observation group significantly increased VAS score,femorotibial angle and knee range of motion,and markedly decreased tibial joint space angle,SAS score and SDS score(P<0.05).Conclusion The combined treatment with PFO and arthroscopic debridement for KOA can effectively improve clinical outcomes and relieve pain and its effect on knee joint function through reducing the gravity of fibula and enhancing peripheral soft tissue reconstruction.