腓骨近端截骨术联合膝关节镜清理术治疗内翻型膝骨关节炎患者的效果

Effects of proximal fibular osteotomy combined with knee arthroscopic debridement in treatment of patients with varus knee osteoarthritis

目的:观察腓骨近端截骨术联合膝关节镜清理术治疗内翻型膝骨关节炎(KOA)患者的效果。方法:选取2018年1月至2021年12月该院收治的84例内翻型KOA患者进行前瞻性研究,按照随机数字表法将其分为观察组与对照组各42例。对照组采用膝关节镜清理术治疗,观察组在对照组基础上采用腓骨近端截骨术治疗,比较两组美国特种外科医院膝关节量表(HSS)评分、视觉模拟评分法(VAS)评分、血清炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平和并发症发生率。结果:术后6个月,两组HSS评分均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05);术后3、6个月,观察组VAS评分低于对照组,差异均有统计学意义(P<0.05);术后3个月,两组血清IL-6、TNF-α水平均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:腓骨近端截骨术联合膝关节镜清理术治疗内翻型KOA患者可提高其术后HSS评分,降低其术后VAS评分和血清IL-6、TNF-α水平,效果优于单纯膝关节镜清理术治疗。

Objective:To observe effects of proximal fibular osteotomy combined with knee arthroscopic debridement in treatment of patients with varus knee osteoarthritis(KOA).Methods:A prospective study was conducted on 84 patients with varus KOA admitted to the hospital from January 2018 to December 2021.They were divided into observation group and control group according to the random number table method,42 cases in each.The control group was treated with arthroscopic debridement,while the observation group was treated with proximal fibular osteotomy on the basis of that of the control group.The American Special Surgery Hospital Scale(HSS)score,the visual analogue scale(VAS)score,the serum inflammatory factor levels[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],and the incidence of complications were compared between the two groups.Results:6 months after the surgery,the HSS scores of the two groups were higher than those before the surgery,that in the observation group was higher than that in the control group,and the differences were statistically significant(P<0.05).3 and 6 months after the surgery,the VAS scores of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).3 months after the surgery,the levels of serum IL-6 and TNF-αin the two groups were lower than those before the surgery,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusions:Proximal fibular osteotomy combined with arthroscopic debridement in the treatment of the patients with varus KOA can improve the postoperative HSS scores,reduce the postoperative VAS scores and the serum IL-6 and TNF-αlevels.Moreover,it is superior to single knee arthroscopic debridement.