腓骨截骨联合关节镜微骨折术对膝关节骨性关节炎患者关节功能及生活质量的影响

Effect of perfibular osteotomy combined with arthroscopic microfracture on joint function and quality of life in patients with knee osteoarthritis

目的研究膝关节骨性关节炎治疗中腓骨截骨联合关节镜微骨折术的应用效果及对患者关节功能及生活质量的影响。方法采用回顾性分析方法,研究对象为2015年1月至2020年1月湖南省中医药研究院附属医院收治入院的65例膝关节骨性关节炎患者,根据不同治疗方式分为两组。对照组(n=32)单用关节镜微骨折术治疗,研究组(n=33)联用腓骨截骨与关节镜微骨折术治疗。比较两组患者手术前后膝关节关节活动度评分、Lysholm膝关节运动功能评分、WOMAC评分、生活质量评分变化与术后并发症(神经损伤、膝关节内黏连、切口感染)发生率。结果两组患者术前膝关节关节活动度评分、Lysholm膝关节运动功能评分、WOMAC评分、生活质量评分比较,差异无统计学意义(P>0.05)。两组患者术后膝关节关节活动度评分、Lysholm膝关节运动功能评分、WOMAC评分、生活质量评分均较术前明显改善,且研究组患者术后各项指标均较同期对照组改善更显著,差异均有统计学意义(P<0.05)。两组患者术后并发症发生率比较,差异无统计学意义(P>0.05)。结论膝关节骨性关节炎治疗中腓骨截骨联合关节镜微骨折术的应用效果显著,可促使患者膝关节功能快速恢复,提升其生活质量,且并发症少,手术安全性高。

Objective To study the effect of perfibular osteotomy combined with arthroscopic microfracture in the treatment of knee osteoarthritis and its effect on joint function and quality of life.Methods A total of 65 patients with knee osteoarthritis admitted to Affiliated Hospital of Hunan Academy of Traditional Chinese Medicine from January 2015 to January 2020 were retrospectively analyzed as the research object,and divided into two groups according to different treatments.The control group(n=32)was treated with arthroscopic microfracture alone,and the study group(n=33)was treated with perfibular osteotomy and arthroscopic microfracture.The changes of knee range of motion score,Lysholm knee motor function score,WOMAC score,quality of life score and the incidence of postoperative complications(nerve injury,internal knee adhesion,incision infection)were compared between 2 groups before and after surgery.Results There were no significant differences in preoperative knee range of motion score,Lysholm knee motor function score,WOMAC score and quality of life score between 2 groups(P>0.05).Knee range of motion score,Lysholm knee motor function score,WOMAC score and quality of life score in 2 groups were significantly improved after surgery compared with that before surgery,and all postoperative indicators in study group were improved more significantly than that in control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of postoperative complications between 2 groups(P>0.05).Conclusion Perfibular osteotomy combined with arthroscopic microfracture in the treatment of knee osteoarthritis has a significant effect,which can promote the rapid recovery of knee function and improve the quality of life of patients,with fewer complications and high surgical safety.