关节镜清理股骨远端截骨治疗膝骨关节炎△（开放获取）

(Open Access) Arthroscopic debridement combined with distal femur osteotomy for treatment of knee osteoarthritis

摘要:

[目的] 评估关节镜清理股骨远端截骨治疗膝骨关节炎的临床疗效。[方法] 回顾性分析2019 年2 月—2022 年2 月本科收治的56 例膝骨关节炎患者的临床资料。评价临床及影像结果。[结果] 所有患者均顺利完成手术，术中无神经血管损伤等严重并发症。随访时间平均（21.6±2.7） 个月，与术前相比，末次随访时，患者VAS 评分[(6.2±0.9), (0.5±0.5), P=0.003] 显著减少，KSS 评分[(36.4±8.1), (81.4±1.1), P＜0.001] 、膝ROM [(130.1±0.3)°, (139.3±0.4)°, P＜0.001] 显著增加。影像方面，与术前相比，末次随访时，患者股颈角（femorotibial angle, FTA） [(80.6±0.4)°, (87.4±0.3)°, P=0.002]、股骨远端外侧机械角（mechanical lateraldistal femoral angle, mLDFA） [(167.7±2.8)°, (176.8±0.2)°, P＜0.001] 均显著增加，所有患者均无骨不连、钢板断裂等并发症。[结论] 关节镜清理股骨远端截骨治疗膝骨关节炎，可以减轻患者症状，延缓骨性关节炎的进展。

Abstract:

[Objective] To evaluate the clinical outcome of arthroscopic debridement combined with distal femoral osteotomy for kneeosteoarthritis. [Methods] A retrospective study was done on 56 patients who received abovesaid treatment for knee osteoarthritis in our de-partment from February 2019 to February 2022. The clinical and imaging data were evaluated. [Results] All patients had operation per-formed successfully, with no serious complications, such as neurovascular injury, and followed up for a mean of (21.6±2.7) months. Com-pared with the preoperative results, VAS score significantly reduced [(6.2±0.9), (0.5±0.5), P=0.003], KSS score [(36.4±8.1), (81.4±1.1), P＜0.001], knee ROM [(130.1±0.3)°, (139.3±0.4)°, P＜0.001] increased significantly at the last follow-up. In term of imaging, the patients hadfemorotibial angle (FTA) [(80.6±0.4)°, (87.4±0.3)°, P=0.002], mechanical lateral distal femoral angle (mLDFA) [(167.7±2.8)°, (176.8±0.2)°,P＜0.001] significantly increased at the last follow-up compared with those preoperatively, with no complications, such as bone nonunion orplate fracture found in anyone of them. [Conclusion] Arthroscopic debridement combined with distal femoral osteotomy for the treatment ofknee osteoarthritis can relive the symptoms and delay the progression of osteoarthritis.