[1]李晓敏,田向东△,谭冶彤,等.单侧胫骨高位截骨术后对侧膝关节疼痛和功能的改变[J].中国中医骨伤科杂志,2023,31(05):24-29.[doi:10.20085/j.cnki.issn1005-0205.230505]
　LI Xiaomin,TIAN Xiangdong,TAN Yetong,et al.Changes of Pain and Function of Contralateral Knee Joint after Unilateral High Tibial Osteotomy[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2023,31(05):24-29.[doi:10.20085/j.cnki.issn1005-0205.230505]
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单侧胫骨高位截骨术后对侧膝关节疼痛和功能的改变()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第31卷
期数:
2023年05期
页码:
24-29
栏目:
临床研究
出版日期:
2023-05-15

文章信息/Info

Title:
Changes of Pain and Function of Contralateral Knee Joint after Unilateral High Tibial Osteotomy
文章编号:
1005-0205(2023)05-0024-06
作者:
李晓敏1; 2; 田向东3△; 谭冶彤3; 丁天送1; 2; 刘昂1; 2
1北京中医药大学研究生院(北京,100029)
2北京中医药大学第三临床医学院
3北京中医药大学第三附属医院
Author(s):
LI Xiaomin1; 2; TIAN Xiangdong3△; TAN Yetong3; DING Tiansong1; 2; LIU Ang1; 2
1Graduate School of Beijing University of Chinese Medicine,Beijing 100029,China;
2The Third School of Clinical Medicine,Beijing University of Chinese Medicine,Beijing 100029,China;
3The Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing 100029,China.
关键词:
单侧胫骨高位截骨术;  对侧膝关节;  疼痛;  功能
Keywords:
high tibial osteotomy;  non-operative limb knee joint;  pain;  function
分类号:
R684.3
DOI:
10.20085/j.cnki.issn1005-0205.230505
文献标志码:
A
摘要:
目的:探究单侧胫骨高位截骨术后对侧膝关节疼痛和功能的改变。方法:回顾性分析2020年1月至2021年10月接受胫骨高位截骨术治疗的50例双膝骨关节炎患者的临床及影像资料。其中男18例,女32例; 年龄为53～82岁,平均为(65.10±5.70)岁。在术前及末次随访时测量双下肢力线比率(WBLR)及双膝胫骨近端内侧角(MPTA)来评价下肢力线及角度改变,在术前、术后1个月、6个月及12个月采用视觉疼痛模拟量表(VAS)评分、西安大略与麦克马斯特大学(WOMAC)骨关节炎指数评分及Lysholm评分来评价双膝关节疼痛及功能改变情况,在术前及末次随访时采集患者对于非术肢接受手术的意愿。结果:所有患者均完成手术并获得完整随访,手术及随访期间未发生不良反应及严重并发症。末次随访时,术肢的下肢力线比率及胫骨近端内侧角均较术前矫正明显,差异有统计学意义(P<0.05); 末次随访时,非术肢的下肢力线比率及胫骨近端内侧角与术前相比差异无统计学意义(P>0.05)。术后随时间的改变,术肢的VAS评分、WOMAC评分及Lysholm评分均较术前明显改善,差异有统计学意义(P<0.05)。术后随时间的改变,非术肢膝关节的VAS评分、WOMAC评分及Lysholm评分均较术前明显改善,差异有统计学意义(P<0.05)。末次随访时,非术肢因临床症状接受手术的患者数量显著下降,差异有统计学意义(P<0.05)。结论:双侧膝骨关节炎患者接受胫骨高位截骨术治疗的术肢下肢力线矫正明显,膝关节疼痛和功能明显改善; 同时,对侧膝关节的疼痛和功能也较术前有明显改善。
Abstract:
Objective:To investigate the changes of pain and function of the contralateral knee joint after unilateral high tibial osteotomy(HTO).Methods:The clinical and imaging data of 50 patients with osteoarthritis of both knees who received high tibial osteotomy from January 2020 to October 2021 were retrospectively analyzed.There were 18 males and 32 females,ranging in age from 53 to 82 years old,with(65.10±5.70)years old on average.Weight bearing limb ratio(WBLR)of lower limbs and medial proximal tibial angle(MPTA)of both knees were measured before surgery and at the last follow-up to evaluate the changes in the angle of force line of lower limbs.Visual analogue scale(VAS)score,Western Ontario and McMaster Universities(WOMAC)score and Lysholm score were used before surgery,1 month after surgery,6 months after surgery and 12 months after surgery to evaluate the pain and functional changes of both knees.The patients' willingness to undergo surgery on the non-operative limb was collected before surgery and at the last follow-up.Results:All patients completed the operation and were followed up.No adverse reactions or serious complications occurred during the operation and follow-up.At the last follow-up,WBLR and MPTA of the operative limb were significantly higher than those of the preoperative correction,the difference was statistically significant(P<0.05).At the last follow-up,WBLR and MPTA of non-operative limbs were not significantly different from those before surgery(P>0.05).After surgery,the VAS score,WOMAC score and Lysholm score were significantly improved compared with those before surgery,and the difference was statistically significant(P<0.05).After surgery,VAS score,WOMAC score and Lysholm score of non-operative limbs were significantly improved compared with those before surgery,and the difference was statistically significant(P<0.05).At the last follow-up,the number of patients with non-operative limbs who received surgery for clinical symptoms also decreased significantly,the difference was statistically significant(P<0.05).Conclusion:In bilateral knee osteoarthritis patients,the lower limb force line of the operative limb treated with HTO was significantly corrected,and the knee joint pain and function were significantly improved; At the same time,the pain and function of the opposite knee joint were also significantly improved compared with those before operation.

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备注/Memo

备注/Memo:
基金项目:北京中医药大学重点攻关项目(2020-JYB-ZDGG-142-5)
△通信作者 E-mail:C083@bucm.edu.cn
更新日期/Last Update: 2023-05-10