实用医学杂志 ›› 2021, Vol. 37 ›› Issue (8): 1031-1036.doi: 10.3969/j.issn.1006⁃5725.2021.08.013

• 临床研究 • 上一篇    下一篇

内侧开放与外侧闭合胫骨高位截骨治疗内侧间室膝骨性关节炎的早期疗效对比

沈高波, 崔龙慷, 方源,李学飞, 李振, 吴连国2   

  1. 1 浙江中医药大学第二临床医学院(杭州 310053);2 浙江中医药大学附属第二医院骨科(杭州 310005)

  • 出版日期:2021-04-25 发布日期:2021-04-25
  • 通讯作者: 吴连国 E⁃mail:mdwu8535@126.com
  • 基金资助:

    浙江省“十三五”中医药重点专科项目(编号:浙卫 办中医[2019]1 号);2017 年浙江省高校中青年学科带头人培养 对象项目(编号:浙教办高科[2017]68 号);国家中医临床研究基 地支撑学科建设计划(编号:2020⁃JDXK⁃ZC01)

Analysis of early efficacy of medial opening ⁃ wedge vs. lateral closed ⁃ wedge high tibial osteotomy in the treatment of medial compartment knee osteoarthritis

SHEN Gaobo,CUI Longkang,FANG Yuan,LI Xue⁃ fei,LI Zhen,WU Lianguo.   

  1. The Second Clinical Medical College of Zhejiang Chinese Medicine University,Hang⁃ zhou 310053,China

  • Online:2021-04-25 Published:2021-04-25
  • Contact: WU Lianguo E⁃mail:mdwu8535@126.com

摘要:

目的 对比内侧开放(OWHTO)与外侧闭合(CWHTO)胫骨高位截骨治疗膝关节内侧间室骨性关节的临床疗效。方法 回顾性分析 2014 1 月至 2018 12 月收治的膝关节内侧间室骨性关节炎患者 48 例,其中采用 OWHTO 术式 25 例,采用 CWHTO 术式 23 例。术后定期随访,测量髋膝踝角(HKA)及 胫骨近端内侧角(MPTA),采用疼痛视觉模拟评分(VAS)和膝关节 HSS 评分评估疼痛和膝关节功能。 结果 OWHTO 组和 CWHTO 组术前 MPTA 角度、HKA 角度、HSS 评分和 VAS 评分对比差异无统计学意义 P > 0.05);末次随访时,OWHTO 组和 CWHTO MPTA 角度分别为(90.47 ± 1.15)°、(90.95 ± 1.18)°,HKA 角度分别为(180.25 ± 1.55)°、(180.91 ± 2.03)°,组间差异无统计学意义(P > 0.05),但分别与术前对比,差异有统计学意义(P < 0.05);末次随访时,OWHTO 组和 CWHTO HSS 评分别为(84.60 ± 2.29)、(85.30 ± 1.55)分,组间差异无统计学意义(P > 0.05),但与术前对比,差异有统计学意义(P < 0.05)。结论 OWHTO 和CWHTO 术式对于膝关节内侧间室骨关节炎具有良好的临床疗效,两种术式的早期疗效未见明显差异。

关键词:

Abstract:

Objective To compare the clinical efficacy of medial opening⁃wedge with lateral closed⁃wedge high tibial osteotomy for medial compartment osteoarthrosis of the knee. Methods A retrospective analysis was performed on 48 patients with medial compartment osteoarthritis of the knee treated from January 2014 to December 2018,including 25 receiving OWHTO and 23 receiving CWHTO. The hip,knee and ankle angles(HKA)and proximal medial tibia angles(MPTA)were measured during regular postoperative follow ⁃ up,and pain and knee function were assessed by visual analogue scale(VAS)and knee HSS scores. Results There were no statistical significant differences in preoperative MPTA,HKA,HSS and VAS scores between OWHTO and CWHTO groups (P > 0.05). At the last follow⁃up,the MPTA angle was(90.47 ± 1.15)° in OWHTO group and(90.95 ± 1.18)° in CWHTO group,and the HKA angle was(180.25 ± 1.55)° and(180.91 ± 2.03)°,respectively. There were no statistical significances between the groups(P > 0.05),but there were significant differences from the preoperative comparison(P < 0.05). At the last follow ⁃ up,the HSS score was(84.60 ± 2.29)points in OWHTO group and (85.30 ± 1.55)points in CWHTO group. There was no statistical significance(P > 0.05)between the two groups but as compared with that before surgery,there was significant difference(P < 0.05). Conclusions OWHTO and CWHTO have a better clinical efficacy for medial compartment osteoarthritis of the knee,and there is no signifi⁃ cant difference in the early efficacy between the two procedures.

Key words:

high tibial osteotomy, medial opening?wedge osteotomy, lateral closed?wedge osteotomy, osteoarthritis