BMI对骨关节炎患者行胫骨高位开放楔形截骨术后疗效的影响分析

The Effect of Body Mass Indexon the Outcome of Patients with Osteoarthritis After Open Wedge High Tibial Osteotomy

目的探讨身体质量指数(body mass index,BMI)对膝关节内侧间室骨关节炎(osteoarthritis,OA)患者实施胫骨高位开放楔形截骨治疗效果的影响。方法选取2018年1月至2021年1月唐都医院收治的100例膝关节内侧间室OA患者作为本次研究对象,根据患者BMI分为A组[52例,男30例,女22例;年龄40~60岁,平均(50.28±4.27)岁;BMI≥24 kg/m^(2)]与B组[48例,男19例,女29例;年龄40~58岁,平均(50.39±4.11)岁;BMI<24 kg/m^(2)]。所有入选患者均实施胫骨高位开放楔形截骨术治疗,观察术前与术后3个月患者Tegner膝关节运动评分、西安大略和麦克马斯特大学(the Western Ontario and McMaster Universities,WOMAC)骨关节炎指数、膝关节功能以及生活质量等指标变化情况。结果术后B组患者Tegner及WOMAC评分均显著优于A组,差异有统计学意义(P<0.05);B组患者术后疼痛、关节活动范围、伸展受限、内外翻畸形、步行功能以及日常生活活动等水平均较A组更优(P<0.05);B组患者术后的生活质量水平显著优于A组(P<0.05)。结论膝关节内侧间室OA患者临床治疗中选用胫骨高位开放楔形截骨术虽能明显提高患者膝关节功能改善效果,且膝关节运动功能也更好,但患者BMI会对其手术疗效造成一定的影响,因此临床治疗OA患者时,应充分考虑患者BMI的影响因素,为其选择更为合适的治疗方式,以最大限度提升手术效果。

Objective To investigate the effect of body mass index(BMI)on high tibial open wedge osteotomy in patients with osteoarthritis(OA)of the medial compartment of the knee joint.Methods From January 2018 to January 2021,100 patients with OA of the medial compartment of the knee were enrolled in Tangdu Hospital.The patients with BMI≥24 kg/m^(2) were divided into group A(52 patients;30 male,22 female).The age was(50.28±4.27)years(range,40~60 years).The patients with BMI<24 kg/m^(2) were divided into group B(48 patients;19 male,29 female).The age was(50.39±4.11)years(range,40~58 years).All patients underwent open wedge high tibial osteotomy(OWHTO),the changes of Tegner knee movement score,the Western Ontario and McMaster University(WOMAC)arthritis index score,knee function and quality of life were observed before and 3 months after operation.Results The scores of Tegner and WOMAC in group B were significantly higher than those in group A(P<0.05).The level of pain,range of motion,limitation of movement and extension,varus and varus deformity,walking function and activities of daily living in group B were better than those in group A(P<0.05).The quality of life in group B was significantly better than those in group A(P<0.05).Conclusion OWHTO can improve the knee joint function and improve the knee joint motion function in patients with medial compartment osteoarthritis.But the BMI of the patients will affect the curative effect of the operation to some extent.Therefore,we should consider the influencing factors of the BMI of the patients when we treat the patients with OA,and choose a more suitable treatment method for them to maximize the effect of surgery.