腓骨上段截骨治疗膝关节骨关节炎

Proximal fibular osteotomy for treatment of medial knee osteoarthritis

摘要:

[目的]探讨腓骨上段截骨(proximal fibular osteotomy, PFO)治疗膝关节内侧骨关节炎(knee osteoarthritis, KOA)的临床疗效、安全性及其优点。[方法] 回顾性分析 2020 年 2 月—2021 年 2 月本院采用 PFO 治疗的内侧 KOA 患者 60 例，比较各时期的 VAS 评分、HSS 评分、KSS 评分。[结果] 不良事件方面，2 例 (3.33%) 患者肌间静脉血栓形成，1 例 (1.67%) 患者母背伸活动度受限，2 例 (3.33%) 患者母短肌肌腱挛缩，1 例 (1.67%) 患者腓总神经损伤。随时间推移，患者的 VAS 评分显著下降(P＜0.05)，而 HSS 评分、KSS 临床评分和 KSS 功能评分均显著增加(P＜0.05)。末次随访时，60 例患者中，43 例 (71.67%) 膝内侧无疼痛，15 例 (25.00%) 患者膝内侧疼痛明显减轻，1 例 (1.67%) 疼痛位置改变，1 例 (1.67%) 疼痛无变化。[结论]PFO 是安全、微创、低成本的手术治疗方式，可明显缓解 KOA 患者疼痛，改善功能。

Abstract:

[Objective] To explore the clinical efficacy, safety and advantages of proximal fibular osteotomy (PFO) for treatment of me- dial knee osteoarthritis (KOA) . [Methods] A retrospective study was conducted on a total of 60 patients who underwent PFO for medial KOA in our hospital from February 2020 to February 2021. The VAS, HSS, KSS clinical and functional scores were compared among differ- ent time points. [Results] In terms of adverse events, intermuscular vein thrombosis was seen in 2 patients (3.33%) , limited motion of hal- lux dorsal extension was noted in 1 patient (1.67%) , hallux brevis contracture was found in 2 patients (3.33%) , and palsy of common pero- neal nerve was in only 1 patient (1.67%) . The VAS score decreased significantly (P＜0.05) , whereas the HSS score, as well as KSS clinical and functional scores significantly increased over time (P＜0.05) . At the last follow-up, 43 patients (71.67%) had no medial knee pain total- ly, 15 patients (25.00%) got medial knee pain significantly relieved, 1 patient (1.67%) had pain location changed, and 1 patient (1.67%) re- mained pain unchanged. [Conclusion] PFO is a safe, minimally invasive and cost-efficient surgical treatment, does obviously relieve the pain and improve the function for medial KOA.