[1]杨勇 赵良虎 黄金 陈超前 罗建军.胫骨内侧高位截骨对单纯内侧间室膝关节骨关节炎患者滑液中炎性因子及软骨降解因子的影响[J].中国中医骨伤科杂志,2021,29(04):73-76.
 YANG Yong ZHAO Lianghu HUANG Jin CHEN Chaoqian LUO Jianjun.Effect of High Medial Tibial Osteotomy on Inflammatory Factors ofSynovial Fluid and Cartilage Degrading Factors of Simple MedialCompartment from Knee Osteoarthritis Patients[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2021,29(04):73-76.
点击复制

胫骨内侧高位截骨对单纯内侧间室膝关节骨关节炎患者滑液中炎性因子及软骨降解因子的影响()
分享到:

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第29卷
期数:
2021年04期
页码:
73-76
栏目:
临床报道
出版日期:
2021-04-15

文章信息/Info

Title:
Effect of High Medial Tibial Osteotomy on Inflammatory Factors ofSynovial Fluid and Cartilage Degrading Factors of Simple MedialCompartment from Knee Osteoarthritis Patients
文章编号:
1005-0205(2021)04-0073-04
作者:
杨勇1 赵良虎1 黄金1 陈超前1 罗建军1
1攀枝花学院附属医院膝关节科(四川 攀枝花,617000)
Author(s):
YANG Yong1 ZHAO Lianghu1 HUANG Jin1 CHEN Chaoqian1 LUO Jianjun1
1Department of Knee Joint,Affiliated Hospital of Panzhihua University,Panzhihua 617000,Sichuan China.
关键词:
胫骨内侧高位截骨术 膝关节骨性关节炎 炎性因子 软骨降解因子
Keywords:
high medial tibial osteotomy knee osteoarthritis inflammatory factors cartilage degradation factors
分类号:
R684.3
文献标志码:
B
摘要:
目的:探讨胫骨内侧高位截骨术治疗单纯内侧间室膝关节骨性关节炎(KOA)后患者滑液中炎性因子及软骨降解因子的影响。方法:收集2017年1月至2019年6月因单纯内侧间室KOA于本院行胫骨内侧高位截骨术的患者30例,收集患者治疗前及治疗后3、6及12个月膝关节WOMCA评分及视觉模拟疼痛评分(VAS),收集患者术前及术后3、6及12个月膝关节滑液,使用ELISA法检测滑液中炎性因子(IL-1β、IL-6、TNF-α)和软骨降解因子(MMP3、MMP9、ADAMTS4)的表达变化。结果:所有患者均获得随访,术后患者伤口均愈合良好,截骨线均骨性愈合,无血管神经损伤等并发症发生。术后3、6及12个月患者VAS及WOMAC评分均显著低于术前(P<0.05)。ELISA结果显示,与术前滑液中炎性因子和软骨降解因子的表达量相比,术后3、6及12个月患者炎性因子及软骨降解因子表达水平显著降低(P<0.05)。结论:胫骨内侧高位截骨术可以有效改善单纯内侧间室KOA患者功能评分,缓解患者疼痛,并可降低滑液中炎性因子及软骨降解因子的表达水平,从而延缓软骨损伤。
Abstract:
To investigate the effects of high medial tibial osteotomy on inflammatory factors of synovial fluid and cartilage degrading factors of simple medial compartment from knee osteoarthritis(KOA)patients.Methods:A total of 30 patients who underwent high medial tibial osteotomy in our hospital for simple medial compartment KOA from January 2017 to June 2019 were collected.The WOMCA,VAS was collected before treatment and 3,6 and 12 months after treatment.Synovial fluid of patients was collected before treatment and 3,6 and 12 months after treatment,and then use ELISA to detect inflammatory factors(IL-1β,IL-6,TNF-α)and cartilage degradation factors(MMP3,MMP9,ADAMTS4)expression.Results:All patients healed well without complications such as vascular or nerve injury.There were followed up for 12 momths.The VAS and WOMAC scores of patients at 3,6 and 12 months after operation were significantly lower than those before operation(P<0.05).ELISA results showed that compared with the expression levels of inflammatory factors and cartilage degrading factors in synovial fluid before surgery,the expression levels of inflammatory factors and cartilage-degrading factors at 3,6 and 12 months after operation were significantly reduced(P<0.05).Conclusion:High medial tibial osteotomy can effectively improve the functional score and relieve pain in the patients with simple medial compartment KOA,and also effectively reduce the expression levels of inflammatory factors and cartilage degradation factors in synovial fluid and delay the cartilage damage.

参考文献/References:

[1] 宋华荣,喻忠,王黎明,等.膝关节单髁置换术治疗单侧胫股间隙骨关节炎的临床研究[J].中华关节外科杂志(电子版),2010,4(1):52-56.
[2] 马云山,房晓慧.关节清理术结合髌骨外侧支持带松解术对髌股关节骨关节炎患者膝关节功能的影响[J].临床研究,2020,28(3):25-27.
[3] 敖仕梅.玻璃酸钠关节腔内注射联合骨骼肌疼痛治疗仪治疗膝骨关节炎患者VAS评分及膝关节功能的影响[J].临床研究,2019,27(11):103-104.
[4] 陈谱,陈岗,陶军.膝关节周围截骨术治疗膝关节内侧间室骨性关节炎研究进展[J].江西中医药,2017,48(7):74-77.
[5] 孙建华,罗本泰,万国生,等.胫骨高位截骨联合关节镜清理术治疗膝内翻型关节炎[J].中国矫形外科杂志,2020,28(9):853-855.
[6] 俞颖豪,赵继军,刘冬铖,等.个体化开放楔形胫骨高位截骨治疗内侧间室膝骨关节炎的优势[J].中国组织工程研究,2020,24(27):4310-4316.
[7] SHIN K H,JUNG J K,NAM J J,et al.Preoperative supine radiographs are more accurate than standing radiographs for preoperative planning in medial open-wedge high tibial osteotomy[J].Arthroscopy: The Journal of Arthroscopic & Related Surgery,2020,36(6):1655-1664.
[8] PALMIERI B,LODI D,CAPONE S.Osteoarthritis and degenerative joint disease:local treatment options update[J].Acta Biomed,2010,81(2):94-100.
[9] DUYMUS T M,MUTLU S,DERNEK B,et al.Choice of intra-articular injection in treatment of knee osteoarthritis:platelet-rich plasma,hyaluronic acid or ozone options[J].Knee Surg Sports Traumatol Arthrosc,2017,25(2):485-492.
[10] 张学登.单髁置换术治疗高龄膝骨关节炎患者的效果及对术后恢复情况的影响[J].临床研究,2019,27(8):85-87.
[11] 李峰.养血软坚胶囊治疗膝骨关节炎疗效及安全性评价[J].临床研究,2018,26(8):125-127.
[12] JORDAN K M,ARDEN N K,DOHERTY M,et al.EULAR Recommendations 2003:an evidence based approach to the management of knee osteoarthritis:report of a task force of the standing committee for international clinical studies including therapeutic trials(ESCISIT)[J].Ann Rheum Dis,2003,62(12):1145-1155.
[13] CHEN P,HUANG L W,ZHANG D,et al.Mobile bearing versus fixed bearing for total knee arthroplasty:meta-analysis of randomized controlled trials at minimum 10-year follow-up[J].J Knee Surg,2020.DOI:10.1055/10.1055/s-0040-1713356.
[14] CHEN P,HUANG L,MA Y,et al.Intra-articular platelet-rich plasma injection for knee osteoarthritis:a summary of meta-analyses[J].Journal of Orthopaedic Surgery and Research,2019,14(1):385-392.
[15] 刘沛,夏子麒,王洋,等.年轻人膝关节骨关节炎的保膝治疗进展[J].中国矫形外科杂志,2020,28(3):248-251.
[16] BAYLISS L E,CULLIFORD D,MONK A P,et al.The effect of patient age at intervention on risk of implant revision after total replacement of the hip or knee:a population-based cohort study[J].Lancet,2017,389:1424-1430.
[17] 陈文祥,赵建宁,包倪荣.白介素单核苷酸多态性与骨关节炎易感性关系的研究进展[J].临床与病理杂志,2016,36(11):1878-1882.
[18] 朱克强,王晨,惠晓艳,等.肿瘤坏死因子α在痛风性关节炎发病机制中的作用研究进展[J].浙江医学,2020,42(6):638-641.
[19] WANG Y,XU J,ZHANG X,et al.TNF-α-induced LRG1 promotes angiogenesis and mesenchymal stem cell migration in the subchondral bone during osteoarthritis[J].Cell Death Dis,2017,8(3):e2715.
[20] KAPOOR M,MARTEL-PELLETIER J,LAJEUNESSE D,et al.Role of proinflammatory cytokines in the pathophysiology of osteoarthritis[J].Nat Rev Rheumatol,2011,7(1):33-42.
[21] YANG C Y,CHANALARIS A,TROEBERG L.ADAMTS and ADAM metalloproteinases in osteoarthritis-looking beyond the ‘usual suspects’[J].Osteoarthritis Cartilage,2017,25(7):1000-1009.
[22] VERMA P,DALAL K.ADAMTS-4 and ADAMTS-5:key enzymes in osteoarthritis[J].J Cell Biochem,2011,112(12):3507-3514.
[23] KLEIN T,BISCHOFF R.Physiology and pathophysiology of matrix metalloproteases[J].Amino Acids,2011,41(2):271-290.

更新日期/Last Update: 2021-04-15