胫骨近端双平面开放截骨术联合关节镜清理治疗膝关节内侧间室骨性关节炎
摘要
目的探讨采用胫骨近端双平面开放截骨术联合关节镜清理治疗膝关节内侧间室骨性关节炎的早期临床疗效。方法回顾性分析自2015-03—2017-06采用胫骨近端双平面开放截骨术联合关节镜下清理治疗的30例膝关节内侧间室骨性关节炎。结果 30例均获得随访,随访时间平均18(10～29)个月。3例术后出现切口皮肤部分脂肪液化,经换药后好转。所有患者术后内翻均矫正,无矫正度数丢失。胫骨平台后倾角无明显变化,无内固定松动、断裂。术后截骨区愈合时间平均6(4～11)个月。末次随访时胫骨近端内侧角平均89.5°(88.6°～92.0°),膝关节屈曲平均119°(110°～130°),疼痛VAS评分平均1.4(1.1～1.9)分。结论胫骨近端双平面开放截骨术联合关节镜清理治疗膝关节内侧间室骨关节炎安全、有效,不仅可以缓解疼痛、矫正畸形、改善关节功能、延缓关节炎进展,而且可使退变的关节软骨得到修复。
引文
[1] Miniaci A,Ballmer FT,Ballmer PM,et al. Proximal tibial osteotomy.A new fixation device[J]. Clin Orthop,1989,246:250-259.
[2] Fujisawa Y,Masuhara K,Shiomi S. The effect of high tibial osteoto-my on osteoarthritis of the knee.An arthroscopic study of 54 kneejoints[J]. Orthop Clin North Am,1979,10(3):585-608.
[3]罗兵,袁毅,杨家福,等.关节腔注射氨甲环酸并夹闭引流管对膝关节单间室骨性关节炎单髁置换术后出血量的影响[J].中国骨与关节损伤杂志,2018,33(6):579-582.
[4]高小康,仝超,韩守江,等. 3D打印个性化截骨模板在全膝关节置换术中的应用[J].中国骨与关节损伤杂志,2018,33(8):802-805.
[5]张建兵,陈百成,王飞,等.胫骨高位截骨联合膝关节镜下外侧支持带松解及清理术的临床疗效评价[J].中国骨与关节损伤杂志,2009,24(7):595-597.
[6] Saito T,Kumagai K,Akamatsu Y,et al. Five-to ten-year outcomefollowing medial opening-wedge high tibial osteotomy with rigidplate fixation in combination with an artificial bone substitute[J].Bone Joint J,2014,96(3):339-344.
[7] Nakamura E,Mizuta H,Kudo S,et al. Open-wedge osteotomy of theproximal tibia with hemicallotasis[J]. J Bone Joint Surg Br,2001,83(8):1111-1115.
[2] Fujisawa Y,Masuhara K,Shiomi S. The effect of high tibial osteoto-my on osteoarthritis of the knee.An arthroscopic study of 54 kneejoints[J]. Orthop Clin North Am,1979,10(3):585-608.
[3]罗兵,袁毅,杨家福,等.关节腔注射氨甲环酸并夹闭引流管对膝关节单间室骨性关节炎单髁置换术后出血量的影响[J].中国骨与关节损伤杂志,2018,33(6):579-582.
[4]高小康,仝超,韩守江,等. 3D打印个性化截骨模板在全膝关节置换术中的应用[J].中国骨与关节损伤杂志,2018,33(8):802-805.
[5]张建兵,陈百成,王飞,等.胫骨高位截骨联合膝关节镜下外侧支持带松解及清理术的临床疗效评价[J].中国骨与关节损伤杂志,2009,24(7):595-597.
[6] Saito T,Kumagai K,Akamatsu Y,et al. Five-to ten-year outcomefollowing medial opening-wedge high tibial osteotomy with rigidplate fixation in combination with an artificial bone substitute[J].Bone Joint J,2014,96(3):339-344.
[7] Nakamura E,Mizuta H,Kudo S,et al. Open-wedge osteotomy of theproximal tibia with hemicallotasis[J]. J Bone Joint Surg Br,2001,83(8):1111-1115.