关节镜联合胫骨高位截骨术治疗膝关节炎的疗效观察

Arthroscopy combined with high tibial osteotomy in the treatment of medial compartment osteoarthritis of knee joint

目的探讨关节镜结合胫骨高位截骨术(High Tibial Osteotomy,HTO)治疗膝关节内侧间室骨关节炎(Anterome⁃dial Osteoarthritis,AMOA)的临床效果。方法回顾性分析2021年1月—2023年10月我院收治的92例AMOA患者临床资料,按治疗方法不同分为两组,将关节镜下清理术治疗的46例设为对照组,将关节镜结合HTO治疗46例设为观察组。比较两组膝关节功能、关节活动度、疼痛评分、下肢活动能力、生活质量及并发症发生情况。结果观察组术后WOMAC评分各维度及总分均低于对照组(P<0.05)。观察组术后关节屈曲、外展、后伸及内收活动度均高于对照组(P<0.05)。观察组术后VAS评分低于对照组,下肢FMA评分高于对照组(P<0.05)。观察组术后各项生活质量评分高于对照组(P<0.05)。两组并发症总发生率相比无差异(P>0.05)。结论关节镜结合HTO治疗AMOA效果更佳,可加快膝关节功能恢复,增加关节活动度,改善患者生活质量,且安全性良好。

Objective To investigate the clinical effect of arthroscopy combined with high tibial osteotomy(HTO)in the treatment of anteromedial osteoarthritis(AMOA).Methods Clinical data of 92 patients with AMOA admitted to our hospital from January 2021 to October 2023 were retrospectively analyzed and divided into two groups according to different treatment methods.46 cases of arthroscopic debridement were set as control group,and 46 cases of arthroscopic combined with HTO were set as observation group.Knee function,joint range of motion,pain score,daily living ability,lower limb mobility,quality of life and complications were compared between the two groups.Results The WOMAC score in the observation group was lower than that in the control group(P<0.05).Postoperative joint flexion,abduction,extension and adduction of the observation group were higher than those of the control group(P<0.05).VAS score of observation group was lower than control group,BI score and lower limb FMA score were higher than control group(P<0.05).The quality of life score of the observation group was higher than that of the control group(P<0.05).There was no difference in complications between the two groups(P<0.05).Conclusion Arthroscopy combined with HTO is more effective in the treatment of AMOA,which can accelerate the functional recovery of knee joint,increase the range of motion,improve the quality of life of patients,and has good safety.