关节镜联合开放胫骨高位截骨术治疗膝关节骨性关节炎的早期疗效对比

Comparative Analysis of Early Efficacy of Arthroscopy Combined with Open High Tibial Osteotomy in the Treatment of Knee Osteoarthritis

目的分析探讨关节镜结合开放胫骨高位截骨术(open wedge high tibial osteotomy,OWHTO)与单纯开放胫骨高位截骨术治疗膝关节骨关节炎的临床疗效。方法回顾性分析2018年1月至2020年1月骨科收治的因膝关节骨关节炎接受手术治疗的34例(39膝)患者的临床资料,根据手术方式分为2组,A组为关节镜联合OWHTO手术治疗的共17例,B组为单纯接受OWHTO手术治疗的共22例。比较2组临床疗效。结果(1)2组患者在术前HSS评分、VAS疼痛视觉模拟评分、膝关节活动度、Lysholm膝关节评分方面的差异均无显著差异,具有可比性;(2)2组患者术后3 d、1月的HSS和、VAS评分、Lysholm膝关节评分有显著差异,A组高于B组,差异有统计学意义(P<0.05);但2组术后3月、6月、12月的HSS和、VAS评分、Lysholm膝关节评分无显著差异;2组患者术后3 d、1月、3月、6月、12月的膝关节活动度均无明显差异(P>0.05)。结论关节镜联合开放胫骨高位截骨术相比较于单纯开放胫骨高位截骨术治疗膝关节骨关节炎早期在疼痛缓解方面能取得较为显著的效果,中远期临床疗效无明显差异。

Objective To analyze the clinical effect of arthroscopy combined with open-wedge high Tibial osteotomy(OWHTO)and open-tibial high osteotomy alone in the treatment of knee osteoarthritis.Methods The clinical data of 34 patients(39 knees)who received surgery for osteoarthritis of the knee in our department from January 2018 to January 2020 were retrospectively analyzed.They were divided into two groups according to the surgical methods.Group A consisted of 17 patients who received arthroscopy combined with OWHTO surgery,and group B consisted of 22 patients who received OWHTO surgery alone.The clinical efficacy of the two groups was compared.Results(1)There were no significant differences in preoperative HSS score,VAS visual simulation score,knee range of motion and Lysholm knee score between the two groups,which makes the two groups comparable.(2)There were significant differences in HSS,VAS and Lysholm knee score between 2 groups 3 days and 1 month after surgery,and group A was higher than group B,with statistical significance(P<0.05);however,there were no significant differences in HSS,VAS score,Lysholm knee score at 3 months,6 months and 12 months postoperatively between the two groups.There was no significant difference in knee joint range of motion between the two groups 3 days,1 month,3 months,6 months and 12 months after operation.Conclusion Arthroscopy combined with open tibial high osteotomy is more effective than open tibial high osteotomy alone in the treatment of early knee osteoarthritis in terms of pain relief,and there is no significant difference in the long-term clinical efficacy.