摘要
目的探讨股骨远端髁上截骨联合关节镜治疗膝外翻骨关节炎的临床疗效。方法采用股骨远端髁上截骨联合关节镜治疗25例膝外翻骨关节炎患者。手术前后测量股骨远端外侧角(m LDFA)、胫股角(FTA)、股胫外翻角、外侧关节间隙,采用疼痛VAS评分、HSS评分评价膝关节疼痛功能情况。记录术后6个月及末次随访时膝关节活动度。结果患者均获得随访,时间10~15个月。术后均未发生感染、延迟愈合、不愈合及下肢深静脉血栓形成等并发症。下肢全长X线片测量显示股胫外翻角术后较术前明显改善(P<0.05)。FTA、m LDFA、外侧关节间隙及HSS评分、疼痛VAS评分术后6个月均较术前明显改善(P<0.001)。膝关节活动度:术后6个月屈曲110°~125°,伸直0°~4°;末次随访时屈曲115°~130°,伸直0°~6°。末次随访时,下肢力线恢复至正常或接近正常水平。结论股骨远端髁上截骨联合关节镜治疗膝外翻骨关节炎,可有效矫正下肢力线,近解剖固定,解除受累间室,最大限度恢复关节功能。
Objective To investigate the effect of distal femoral supracondylar osteotomy combined with arthroscopy in the treatment of knee valgus osteoarthritis.Methods The 25 cases of knee valgus osteoarthritis were treated by distal femoral supracondylar osteotomy combined with arthroscopy.The distal lateral angle of femur(m LDFA),tibiofemoral angle(FTA),tibiofemoral valgus angle and lateral joint space were measured before and after surgery,and the knee pain and function were evaluated by pain VAS and HSS score.Knee range of motion was measured at 6 months after surgery and the last follow-up.Results All patients were followed up for 10~15 months.There were no postoperative complications such as infection,delayed union,nonunion and deep venous thrombosis of lower limbs.The full-length X-ray film of the lower extremities showed that tibiofemoral valgus angle of the lower extremities was significantly improved after operation than the preoperation(P<0.05).At 6 months postoperation,FTA,m LDFA,lateral joint space and HSS scores,pain VAS were significantly improved than the preoperation(P<0.001).Range of motion of the knee:at 6 months after surgery,it was flexion with 110°~125°,extension with 0°~4°;and at the last follow-up,the flexion was 115°~130°and the extension was 0°~6°.At the last follow-up,the force alignment of the lower extremities was restored to normal or close to normal level.Conclusions Distal femoral supracondylar osteotomy combined with arthroscopy are used to treat knee valgus osteoarthritis,which can effectively correct the lower extremity force alignment,reach proximal anatomical fixation,remove the affected compartment,and restore joint function to the maximum extent.
作者
夏玉光
XIA Yu-guang(Dept of Trauma and Joint Surgery,Luoyang Orthopaedic-Traumatological Hospital of Henan Province,Henan Provincial Orthopaedic Hospital,Zhengzhou,Henan 450000,China)
出处
《临床骨科杂志》
2022年第3期380-384,共5页
Journal of Clinical Orthopaedics
关键词
股骨远端髁上截骨
关节镜检查
膝外翻骨关节炎
distal femoral supracondylar osteotomy
arthroscopy
knee genu valgus osteoarthritis
作者简介
夏玉光,男,副主任医师,主要从事创伤关节及保髋保膝阶梯化诊疗研究,E-mail:xiayuguang@yeah.net。
