改良内侧开放式胫骨高位截骨术治疗膝内侧间室骨性关节炎

目的探索新型改良内侧开放式胫骨高位截骨术(High tibial osteotomy,HTO)治疗膝内侧间室骨性关节炎的有效性和安全性。方法选择2017年7月到2018年7月在我院接受改良内侧开放式HTO的60位膝内侧间室骨性关节炎患者作为研究对象。记录每位患者的手术时间、出血量及手术并发症,并分别于术前和术后3、6个月对患者进行疼痛视觉评分(VAS)和美国膝关节协会评分(KSS评分);比较患者手术前后的胫股角、平台后倾角的影像学治疗。结果术后3、6个月的VAS评分和KSS评分均优于术前(P<0.001),且术后随着时间推移评分存在逐渐好转趋势。患者术后胫股角较术前胫股角减小(P<0.005),术后胫骨后倾角与术前无明显差异(P>0.05)。结论改良内侧开放式HTO治疗膝内侧间室骨性关节炎可显著缓解疼痛症状,重建膝关节功能。

A Modified Medial Open High Tibial Osteotomy for the Treatment of Medial Compartmental Osteoarthritis of the Knees

Objective To explore the effect and safety of a modified medial open high tibial osteotomy in the treatment of medial compartmental osteoarthritis of the knee.Methods From July 2017 to July 2018,60 patients(60 knees)were treated with modified medial open high tibial osteotomy.The operation time,intraoperative bleeding and surgical complications were recorded.The visual analogue score(VAS)for pain and American Knee Society knee score(KSS)were used for evaluation of the clinical condition before operation,3 and 6 months after operation respectively.Besides,tibiofemoral angles and posterior slope angles of tibial plateau were also compared before and after operation.Results The VAS score and KSS score at 3 and 6 months after surgery were better than those before surgery(P<0.001),and the postoperative score showed a trend of gradual improvement over time.The tibiofemoral angles after surgery were decreased compared with those before surgery(P<0.005),and the posterior slope angles of tibial plateau after surgery were not significantly different from those before surgery(P>0.05).Conclusion The modified medial open high tibial osteotomy in the treatment of medial compartmental osteoarthritis can significantly relieve pain symptoms and reconstruct knee function.