关节镜和传统开放手术治疗跖筋膜炎合并跟骨骨刺的短期疗效比较

Comparison of Short-Term Outcomes of Arthroscopic and Traditional Open Surgery for Plantar Fasciitis with Calcaneal Spur

目的 比较关节镜微创手术治疗和传统开放手术治疗跖筋膜炎合并跟骨骨刺的短期疗效。方法 回顾性纳入2015年6月至2019年6月我院收治的非手术治疗无效的跖筋膜炎合并跟骨骨刺患者37例,根据手术方式分为关节镜组和开放手术组。比较两组的手术时间、住院时间、负重时间、术后并发症发生情况、美国足踝外科协会踝与后足(AOFAS-AH)评分和术后1、3、6个月的疼痛视觉模拟量表(VAS)。结果 与开放手术组相比,关节镜组手术时间更长,住院时间、开始负重时间短(P <0.05)。关节镜组APFAS-AH评分、术后1、3、6个月VAS评分优于开放手术组(P <0.05)。关节镜组和开放手术组并发症发生情况差异无统计学意义(P> 0.05)。结论 两种治疗方式均能安全、有效改善顽固性跖筋膜炎症状。与开放手术相比,关节镜手术短期主客观功能改善更明显,疼痛减轻更快。

Objective To compare the short-term clinical outcome of minimally invasive arthroscopic and traditional open surgery for the treatment of plantar fasciitis with calcaneal spur.Methods A total of 37 patients diagnosed with recalcitrant plantar fasciitis and heel spur,who treated nonsurgically,were admitted in our hospital from June 2015 to June 2019.Patients were divided into arthroscopic and open surgery group according to the operation method.The operation time,hospital-stay,full weight-bearing time,postoperative complications,American Orthopedic Foot and Ankle score Ankle-Hindfoot(AOFAS-AH),and postoperative 1,3,6 months visual analogue scale(VAS) were compared between the two groups.Results Compared with the open surgery group,the arthroscopic group had significantly longer operation time,shorter hospital-stay,and shorter weight-bearing time(P<0.05).APFAS-AH score and VAS score at 1,3 and 6 months after operation in arthroscopic group were significantly better than those in open surgery group(P<0.05).There was no significant difference in the incidence of complications between the arthroscopic group and the open surgery group(P<0.05).Conclusions Two methods of treatment are safe and effective to improve recalcitrant plantar fasciitis.Compared with open surgery,arthroscopic surgery has more obvious short-term subjective and objective function improvement and faster pain relief.