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关节镜联合开放楔形胫骨高位截骨术对膝关节内侧间室骨性关节炎患者下肢力线矫正及炎性因子水平的影响

Effects of arthroscopy combined with open wedge high tibial osteotomy on lower limb alignment correction and inflammatory factors levels in patients with medial compartment osteoarthritis of knee joint
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摘要 目的探讨关节镜联合开放楔形胫骨高位截骨术对膝关节内侧间室骨性关节炎患者下肢力线矫正及炎性因子水平的影响。方法选取2021年4月至2022年5月我科收治的82例膝关节内侧间室骨性关节炎患者为研究对象,以随机数字表法将其分为对照组(41例,关节镜联合腓骨近端截骨术)和观察组(41例,关节镜联合开放楔形胫骨高位截骨术)。比较两组的手术效果。结果观察组的术中出血量多于对照组,术后下床活动时间长于对照组,差异具有统计学意义(P<0.05)。术后6个月,观察组的下肢力线比率高于对照组,胫骨平台后倾角小于对照组,差异具有统计学意义(P<0.05)。术后6个月,观察组的白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平均低于对照组,差异具有统计学意义(P<0.05)。结论关节镜联合开放楔形胫骨高位截骨术治疗膝关节内侧间室骨性关节炎虽然会增加术中出血量,延长术后下床活动时间,但不增加住院时间,且利于提高下肢力线矫正效果,降低滑液中炎性因子水平。 Objective To explore the effects of arthroscopy combined with open wedge high tibial osteotomy on lower limb alignment correction and inflammatory factors levels in patients with medial compartment osteoarthritis of knee joint.Methods A total of 82 patients with medial compartment osteoarthritis of knee joint admitted in our department from April 2021 to May 2022 were selected as the research objects.The patients were divided into control group(41 cases,arthroscopy combined with proximal fibular osteotomy)and observation group(41 cases,arthroscopy combined with open wedge high tibial osteotomy)by random number table method.The surgical effects of the two groups were compared.Results The intraoperative blood loss in the observation group was more than that in the control group,and the postoperative ambulation time was longer than that in the control group,and the differences were statistically significant(P<0.05).At 6 months after operation,the ratio of lower limb alignment in the observation group was higher than that in the control group,and the posterior slope angle of tibial plateau was smaller than that in the control group,and the differences were statistically significant(P<0.05).At 6 months after operation,the levels of interleukin-1β(IL-1β),interleukin-6(IL-6)and tumour necrosis factor-α(TNF-α)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Arthroscopy combined with open wedge high tibial osteotomy in the treatment of medial compartment osteoarthritis of the knee joint may increase the amount of intraoperative blood loss and prolong the postoperative ambulation time,but it does not increase the length of hospital stay,and can help to improve the correction effect of lower limb alignment and reduce the levels of inflammatory factors in synovial fluid.
作者 白涛 张文生 苗强 杨明智 BAI Tao;ZHANG Wensheng;MIAO Qiang;YANG Mingzhi(No.2 Ward of Orthopaedics Department,Yan'an People's Hospital,Yan'an 716000,China;No.3 Ward of Orthopaedics Department,Yan'an People's Hospital,Yan'an 716000,China;No.1 Ward of Orthopaedics Department,Yan'an People's Hospital,Yan'an 716000,China)
出处 《临床医学研究与实践》 2024年第32期71-74,共4页 Clinical Research and Practice
关键词 关节镜 开放楔形胫骨高位截骨术 膝关节内侧间室骨性关节炎 下肢力线 arthroscopy open wedge high tibia osteotomy medial compartment osteoarthritis of knee joint lower limb alignment
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