胫骨高位截骨治疗膝关节骨性关节炎.doc

胫骨高位截骨治疗膝关节骨性关节炎夏宁晓 1 朱贤平 1 马宁 1 梁志军 2 朱孟勇 1 裴宪武 1 【摘要】目的报道应用胫骨高位截骨术治疗膝关节骨性关节的临床效果。方法选择膝关节内侧间室骨性关节炎伴有膝内翻的患者24例27 膝实施胫骨高位外翻截骨术。结果按 Coventry 的评定标准,根据疼痛缓解、关节活动度及功能恢复三个方面进行疗效评定, 优 12膝,良8膝,可3膝,差1膝。优良率为 83 .3%。结论胫骨高位截骨术治疗膝关节骨性关节炎效果优良。值得推广应用。【关键词】膝关节; 骨性关节炎;截骨术;胫骨 High tibial osteotomy for osteoarthritis of knee Xia Ningxiao, Zhu Xianping, Ma Ning et al. Department of Orthopaedics, Taizhou Central Hospital, Taizhou, Zhejiang 318000 【 Abstract 】 Objective To evaluate the treatment e of high tibial osteotomy for the osteoarthritis of knee. Methods 24 caese 27 knees with osteoarthritis - bowleg were selected for the treatment of high tibial osteotomy. Results According to the evaluation of Coventry ’s scales, excellent and good results were achieved in 20 cases with excellent and good rate of %,based on easement of pain, joint motion and recovery of function. Conclusion The high tibial osteotomy is an effective way for the treatment of osteoarthritis of knee if operative indication is suitable. 【 Key words 】 knee ; osteoarthritis ; osteotomy ; tibia 自 1958 年, J ackson [1] 首先报道了胫骨高位截骨术( High Tibial Osteotomy, 简称 HTO ) 治疗膝关节骨性关节炎以来,已有大量的临床和实验研究证实该法对膝关节骨性关节炎,尤其是以膝内侧间隔为主且伴有膝内翻畸形者具有确切的早期效果。虽然如此, 临床上也有报道其晚期疗效并不尽如人意[2]。我们自 1994 年至 2002 年用该法治疗 24例 27膝, 经半年至 8 年的随访, 效果优良。我们认为严格掌握手术适应症, 以及术前、术中对截骨角度精确的测量是提高疗效的关键。资料与方法一、一般资料本组 24 例, 27 膝,男 6 例,女 18 例。年龄 49岁-78 岁,平均 63 岁。左侧 17 例,右侧 20 例。其中双侧 3 例