中国骨伤2024，Vol.37Issue(9)：886-892,7.DOI:10.12200/j.issn.1003-0034.20230948
单平面胫骨高位截骨术治疗内翻型膝骨关节炎合并内侧半月板后根损伤的临床疗效
High tibial osteotomy on varus knee osteoarthritis with medial meniscus posterior root injury
摘要
Abstract
Objective To explore clinical effect of distal tibial tubercle-high tibial osteotomy(DTT-HTO)in treating knee osteoarthritis(KO A)with medial meniscus posterior root tear(MMPRT).Methods A retrospective analysis was performed on 21 patients with varus KOA with MMPRT from May 2020 to December 2021,including 3 males and 18 females,aged from 49 to 75 years old with an average of(63.81±6.56)years old,the courses of disease ranged from 0.5 to 18.0 years with an average of(5.9±4.2)years,and 4 patients with grade Ⅱ,14 patients with grade Ⅲ,and 3 patients with grade Ⅳ according to Kellgren-Lawrence;14 patients with type 1 and 7 patients with type 2 according to MMPRT damage classification.The distance of medi-al meniscusextrusion(MME)and weight-bearing line ratio(WBLR)of lower extremity were compared before and 12 months after operation.Visual analogue scale(V AS),Western Ontarioand and McMaster Universities(WOMAC)osteoarthritis index,and Lysholm knee score were used to evaluate knee pain and functional improvement before operation,1,6 and 12 months after operation,respectively.Results Twenty-one patients were followed up for 12 to 18 months with an average of(13.52±1.72)months.MME distance was improved from(4.99±1.05)mm before operation to(1.87±0.76)mm at 12 months after operation(P＜0.05).WBLR was increased from(15.49±7.04)％before operation to(62.71±2.27)％at 12 months after operation(P＜0.05).VAS was decreased from(7.00±1.14)before operation to(2.04±0.80),(0.90±0.62)and(0.61±0.50)at 1,6 and 12 months after operation.WOMAC were decreased from preoperative(147.90±9.88)to postoperative(103.43±8.52),(74.00±9.54)and(47.62±9.53)at 1,6 and 12 months,and the difference were statistically significant(P＜0.05).Lysholm scores were increased from(46.04±7.34)before oepration to(63.19±8.93),(81.10±6.41)and(89.29±3.04)at 1,6 and 12 months after operation(P＜0.05).Conclusion For the treatment of varus KOA with MMPRT,DTT-HTO could reduce medial meniscus pro-trusion distance,improve the ratio of lower limb force line,and effectively reduce knee pain and improve knee joint function.关键词
截骨术/膝骨关节炎/内侧半月板后根损伤/内侧半月板突出Key words
Osteotomy/Knee osteoarthritis/Medial meniscus posterior root tear/Medial meniscusextrusion分类
医药卫生引用本文复制引用
王春久,田向东,谭冶彤,薛志鹏,张伟,李晓敏,刘昂..单平面胫骨高位截骨术治疗内翻型膝骨关节炎合并内侧半月板后根损伤的临床疗效[J].中国骨伤,2024,37(9):886-892,7.基金项目
北京中医药大学重点攻关项目(编号:2020-JYB-ZDGG-142-5)Key Research Projects of Beijing University of Chinese Medicine(No.2020-JYB-ZDGG-142-5) （编号:2020-JYB-ZDGG-142-5）
