镜下清理腓骨截骨治疗膝内侧室骨性关节炎

Arthroscopic debridement combined with proximal fibular osteotomy for medial knee osteoarthritis

[目的]探讨镜下膝关节清理联合腓骨近端截骨治疗膝内侧间室骨性关节炎的早期疗效。[方法]回顾性分析2017年7月—2019年7月收治的25例膝关节内侧室骨性关节炎患者的临床资料。其中,12例行单纯关节镜清理,13例行关节镜清理加腓骨段切除。比较两组患者临床与影像资料。[结果]两组均顺利完成手术,无神经、血管损伤等严重并发症。术后12个月,清理截骨组疼痛视觉模拟评分(visual analogue scale, VAS)和美国特种外科医院(Hospital for Speical Surgery,HSS)膝关节评分,以及正位X线片测量的股骨胫骨角(femorotibial angle, FTA)均优于单纯清理组(P<0.05)。[结论]镜下清理联合腓骨截骨可有效治疗早中期的膝关节骨性关节炎,与单纯清理相比可更好地改善下肢力线。

[Objective] To explore the early clinical outcomes of arthroscopic debridement combined with proximal fibular osteotomy for medial knee osteoarthritis. [Methods] A total of 25 patients with medial knee osteoarthritis in Kellgren-Lawrecne Stage II and III underwent minimally invasive surgeries in our hospital from July 2017 to July 2019. Of them, 12 patients received arthroscopic debridement only(the AD group), while the remaining 13 patients received arthroscopic debridement combined with proximal fibular osteotomy(the combined group). The documents regarding to clinical presentations and radiographs were compared between the two groups. [Results] All the patients in both groups had surgical procedures performed smoothly without serious complications, such as neurovascular injuries. The combined group proved significantly superior to the AD group in terms of VAS and HSS scores, as well as femorotibial angle(FTA) measured on anteroposterior X-ray film at 12 months postoperatively(P<0.05). [Conclusion] The arthroscopic debridement combined with proximal fibular osteotomy does treat the medial KOA in early and middle-stage effectively, with an advantage of improvement of lower limb alignment over the arthroscopic debridement only.