关节镜手术联合胫骨高位截骨治疗内侧膝关节骨关节炎的临床研究

目的:观察关节镜手术联合胫骨高位截骨(HTO)治疗内侧膝关节骨关节炎(KOA)的临床疗效。方法:本研究为回顾性研究,将2018年2月~2020年9月间在我院接受治疗的内侧KOA患者63根据手术方式的不同分为A组和B组,分别为30例和33例。A组进行HTO手术,B组进行关节镜手术联合HTO治疗。术前、术后6周、术后12周采用美国纽约特种外科医院(HSS)评分、视觉模拟量表(VAS)评分评价两组患者膝关节功能、疼痛情况。采用36项简明健康状况调查表(SF-36)评价两组患者术前与术后12周的生活质量变化情况。记录两组术后并发症发生情况。术前、术后12周采用MB-Ruler软件测量两组患者机械胫骨近端内侧角(mMPTA)、解剖股胫角(aFTA)。结果:术后6周、术后12周,B组HSS评分高于A组,VAS评分低于A组(P<0.05)。术后12周,B组SF-36量表各维度评分高于A组(P<0.05)。术后3周,B组mMPTA、aFTA小于A组(P<0.05)。两组术后并发症发生率组间对比无差异(P>0.05)。结论:相对于单纯的HTO手术,关节镜手术联合HTO治疗内侧KOA患者,可有效促进膝关节功能改善,减轻疼痛症状,调整下肢力线,近期疗效肯定。

Clinical Study of Arthroscopic Surgery Combined with High Tibial Osteotomy in the Treatment of Medial Knee Osteoarthritis

Objective:To observe the clinical effect of arthroscopic surgery combined with high tibial osteotomy(HTO)in the treatment of medial knee osteoarthritis(KOA).Methods:This study was a retrospective study,63 patients with medial KOA who received treatment in our hospital from February 2018 to September 2020 were divided into group A and group B according to different surgical methods,with 30 cases and 33 cases,respectively.Group A received HTO surgery,and group B received arthroscopic surgery combined with HTO treatment.The New York USA Hospital for Special Surgery(HSS)score and visual analogue scale(VAS)score were used to evaluate knee function and pain in two groups before,6 weeks and 12 weeks after operation.36 item brief health status questionnaire(SF-36)was used to evaluate the changes of quality of life before and 12 weeks after operation in two groups.The incidence of postoperative complications in two groups was recorded.The mechanical proximal medial tibial Angle(mMPTA)and anatomical femoral tibial Angle(aFTA)were measured by MB-Ruler software before and 12 weeks after operation.Results:6 weeks and 12 weeks after operation,HSS score of group B was higher than that of group A,and VAS score was lower than that of group A(P<0.05).12 weeks after operation,the scores of each dimension of SF-36 scale of group B were higher than those of group A(P<0.05).3 weeks after operation,mMPTA and aFTA in group B were lower than those in group A(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion:Compared with simple HTO surgery,arthroscopic surgery combined with HTO in the treatment of patients with medial KOA can effectively promote the improvement of knee function,relieve pain symptoms,adjust the lower limb line,and the short-term effect is certain.