[1]祁超,周婷婷,郭东辉,等.个性化截骨导板辅助胫骨高位截骨术治疗膝关节骨性关节炎的临床效果[J].中国中医骨伤科杂志,2022,30(09):20-25+30.
　QI Chao,ZHOU Tingting,GUO Donghui,et al.Clinical Efficacy of Personalized Osteotomy Guide Assisted Tibial High Osteotomy on the Treatment of Knee Osteoarthritis[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2022,30(09):20-25+30.
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个性化截骨导板辅助胫骨高位截骨术治疗膝关节骨性关节炎的临床效果()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第30卷
期数:
2022年09期
页码:
20-25+30
栏目:
临床研究
出版日期:
2022-09-15

文章信息/Info

Title:
Clinical Efficacy of Personalized Osteotomy Guide Assisted Tibial High Osteotomy on the Treatment of Knee Osteoarthritis
文章编号:
1005-0205(2022)09-0020-06
作者:
祁超1; 周婷婷1; 郭东辉1; 赵云超1; 董军1; 孟郑鑫1; 李晓明1△
1河北省沧州中西医结合医院(河北 沧州,061000)
Author(s):
QI Chao1; ZHOU Tingting1; GUO Donghui1; ZHAO Yunchao1; DONG Jun1; MENG Zhengxin1; LI Xiaoming1△
1Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou 061000,Hebei China.
关键词:
膝关节骨性关节炎;  个性化截骨导板;  开放楔形胫骨高位截骨术;  前交叉韧带;  膝关节功能
Keywords:
knee osteoarthritis;  personalized osteotomy guide;  open wedge high tibial osteotomy;  anterior cruciate ligament;  knee function
分类号:
R684.3
文献标志码:
A
摘要:
目的:探讨个性化截骨导板辅助胫骨高位截骨治疗膝关节骨性关节炎(Knee Osteoarthritis,KOA)的临床效果。方法:选取2020年5月至2021年5月60例KOA患者,采用随机数字表法分为对照组和导板组(各30例),对照组行内侧开放楔形胫骨高位截骨术(Opening Wedge High Tibial Osteotomy,OWHTO)治疗,导板组行个性化截骨导板辅助内侧OWHTO治疗。比较两组手术情况、并发症发生情况及手术前后创伤应激指标(C反应蛋白(Creactive Protein,CRP)、P物质(Substance P,SP)、前列腺素E2(Prostaglandin,PGE2))、前交叉韧带(ACL)形态和功能指标(ACL长度、体部宽度、胫骨前移量)、膝关节功能(美国膝关节协会评分(American Knee Society Knee Score,KSS)、美国特种外科医院膝关节评分(Hospital for Special Surgery Knee Score,HSS))、髋膝踝角(Hip-Knee-Ankle Angle,HKA)、胫骨近端内侧角(Medial Proximal Tibial Angle,MPTA)。结果:导板组手术时间、术中出血量、透视次数均少于对照组(P<0.05); 两组术后1 d和3 d血清CRP、SP、PGE2水平均高于术前,但导板组均低于对照组(P<0.05); 对照组术后取内固定时ACL体部宽度低于术前,胫骨前移量高于术前(P<0.05),导板组术后取内固定时ACL体部宽度、胫骨前移量与术前比较,差异无统计学意义(P>0.05); 两组术后3个月、6个月KSS、HSS评分均高于术前(P<0.05); 两组术后3个月、6个月HKA、MPTA均高于术前(P<0.05); 导板组并发症总发生率(13.33%)与对照组(30.00%)比较,差异无统计学意义(P>0.05)。结论:个性化截骨导板辅助OWHTO治疗KOA患者,能缩短手术时间,减轻手术创伤,降低术后创伤应激反应,且能改善ACL形态和功能,膝关节功能恢复良好,具有良好应用价值。
Abstract:
Objective:To explore the clinical efficacy of personalized osteotomy guide assisted by high tibial osteotomy on the treatment of knee osteoarthritis(KOA).Methods:60 patients with KOA from May 2020 to May 2021 were selected and divided into the control group(30 cases)and the guide plate group(30 cases)by random number table method.The control group underwent medial open wedge-shaped tibial high osteotomy(opening wedge high tibial osteotomy,OWHTO),and the guide plate group was treated with personalized osteotomy guide plate assisted medial OWHTO treatment.The surgical conditions,complications,and traumatic stress indicators(C-reactive protein(CRP),substance P(SP),prostaglandin(PGE2)),anterior cruciate ligament(ACL)morphological and functional indicators(ACL length,body width,tibial anterior displacement),knee joint function(American Knee Society Knee Score(KSS),American Hospital for Special Surgery Knee Score(HSS)),hip-knee-ankle angle(HKA),medial proximal tibial angle(MPTA)before and after surgery were compared between the two groups.Results:The operation time,intraoperative blood loss and times of fluoroscopy in the guide group were less than those in the control group(P<0.05),the serum CRP,SP,and PGE2 levels in the two groups were higher than those before operation at 1 d and 3 d after operation,but in the guide group were lower than those in the control group(P<0.05),the width of the ACL body in the control group after internal fixation was lower than that before the operation,and the anterior displacement of the tibia was higher than that before the operation(P<0.05).There was no significant difference in ACL body width and tibial anterior displacement compared with preoperative ones(P>0.05).KSS and HSS scores at 3 and 6 months after operation in both groups were higher than those before operation(P<0.05).3 months and 6 months after operation,HKA and MPTA in both groups were higher than those before operation(P<0.05),there was no statistical difference in the total incidence of complications between the guide plate group(13.33%)and the control group(30.00%)(P>0.05).Conclusion:Personalized osteotomy guide assisted OWHTO on the treatment of KOA patients can effectively shorten the operation time,reduce the surgical trauma,reduce the postoperative traumatic stress response,and can effectively improve the ACL shape and function,while the knee joint function recovers well,which has good application value.

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备注/Memo

备注/Memo:
基金项目:河北省2022年度医学科学研究课题(20220695)
△通信作者 E-mail:258976836@qq.com
更新日期/Last Update: 2022-09-10