胫骨高位截骨辅助关节镜治疗膝关节骨性关节炎的临床效果

Clinical Effect of High Tibial Osteotomy-assisted Arthroscopy in the Treatment of Knee Osteoarthritis

目的探讨胫骨高位截骨(HTO)辅助关节镜治疗膝关节骨性关节炎(OA)的临床效果。方法选取2017年1月—2021年6月收治的OA 75例,根据治疗方案分为对照组35例和观察组40例。对照组采用全膝关节置换术,观察组采用HTO辅助关节镜。观察2组围术期指标、疼痛、膝关节功能及并发症情况。结果观察组手术时间、术后活动时间、术后3 d血红蛋白下降幅度及住院时间均优于对照组(P<0.05)。2组术后不同时间视觉模拟评分法评分较治疗前降低,且观察组低于对照组(P<0.05)。2组术后膝关节活动度、膝关节量表评分、西安大略和麦马斯特大学骨关节炎指数评分及美国膝关节协会评分均较术前改善,且观察组优于对照组(P<0.05)。观察组并发症发生率低于对照组(P<0.05)。结论HTO辅助关节镜治疗OA能有效改善患者膝关节功能,降低并发症发生率。

Objective To investigate the clinical effect of high tibial osteotomy(HTO)-assisted arthroscopy in the treatment of knee osteoarthritis(OA).Methods A total of 75 OA patients admitted from January 2017 to June 2021 were enrolled.According to the treatment plan,they were divided into control group(n=35)and observation group(n=40).Total knee replacement was performed in the control group and HTO-assisted arthroscopy was performed in the observation group.Perioperative related indexes,pain score,knee joint function and complications were observed in the two groups.Results The mean duration of operation,time of postoperative off-bed activity,hemoglobin decrease at 3 d after operation and length of hospital stay in the observation group were better than those in the control group(P<0.05).Visual analogue scale(VAS)scores of the two groups at different time after operation were lower than those before treatment,and the scores were lower in the observation group than in the control group(P<0.05).Knee range of motion,knee scale score,Western Ontario and McMaster University osteoarthritis index score and American Knee Association score were improved in both groups after operation,which were better in the observation group than in the control group(P<0.05).The complication rate in observation group was lower than that in control group(P<0.05).Conclusion HTO-assisted arthroscopy can effectively improve the knee function of OA patients,and reduce the incidence of complications.