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内侧单髁骨关节炎患者膝关节外翻截骨术后的运动恢复

Return to sports after valgus osteotomy of the knee joint in patients with medial unicompartmental osteoarthritis.

作者信息

Saragaglia Dominique, Rouchy René-Christofer, Krayan Ali, Refaie Ramsay

机构信息

Department of Orthopaedic Surgery and Sport Traumatology, Grenoble South Teaching Hospital, 38130, Échirolles, France,

出版信息

Int Orthop. 2014 Oct;38(10):2109-14. doi: 10.1007/s00264-014-2435-6. Epub 2014 Jul 4.

Abstract

PURPOSE

The aim of this article was to evaluate the resumption of physical activity and sports after valgus osteotomy for medial femorotibial osteoarthritis.

METHODS

This series is composed of 83 patients, with 27 females and 56 males. The mean age was 50.4 ± 9.53 years (32-67) at the time of operation. Before the onset of symptoms of knee osteoarthritis, four (4.8%) patients practiced a competitive sport, 44 (53%) one (or more) recreational sport on a regular basis, 17 (20%) occasionally and 18 (21.6%) did not practice any sport but were active. Sixty-two opening wedge high tibial osteotomies were performed as well as 21 double level osteotomies for severe deformity. All the osteotomies were computer-assisted in order to reach the best overcorrection.

RESULTS

At a mean follow up of 5.75 ± 1.3 years (five to nine years), 71 patients (85.5%) resumed sporting activities and 66 (79.5%) felt they had found a sporting level equal to the level prior surgery. The mean Lysholm score increased from 62.51 ± 15.53 points (30-100) pre-operatively to 90.49 ± 8.62 points (55-100) postoperatively (p < 0.001). The Tegner and UCLA scores didn't decrease significantly after surgery (4.53 and 7.14 pre-operatively versus 4.1 and 6.55 postoperatively, p = 0.07 and 0.09). The mean postoperative KOO score was 73.52 ± 17.20. The frequency of sports sessions per week (2.36 ± 1.6) did not decrease significantly after surgery (2.13 sessions, p = 0.34). On the other hand, the duration of activities decreased significantly from 4.68 hours/week ± 4.25 to 3.48 hours/week (p = 0.04). Of the patients who practiced running before surgery 85% (17 of 20) were able to resume this activity.

CONCLUSION

This study demonstrates that knee osteotomies for medial femorotibial osteoarthritis allow the resumption of sustained physical activity such as jogging or skiing downhill in a majority of patients.

摘要

目的

本文旨在评估股骨内侧髁胫股关节炎外翻截骨术后体力活动和运动的恢复情况。

方法

本系列研究共纳入83例患者,其中女性27例,男性56例。手术时的平均年龄为50.4±9.53岁(32 - 67岁)。在膝关节骨关节炎症状出现之前,4例(4.8%)患者进行竞技运动,44例(53%)患者定期进行一项(或多项)休闲运动,17例(20%)患者偶尔运动,18例(21.6%)患者不运动但身体活跃。共进行了62例开放性楔形高位胫骨截骨术以及21例严重畸形的双平面截骨术。所有截骨术均采用计算机辅助,以实现最佳的过度矫正。

结果

平均随访5.75±1.3年(5至9年),71例(85.5%)患者恢复了体育活动,66例(79.5%)患者感觉他们达到了与手术前相当的运动水平。Lysholm评分术前平均为62.51±15.53分(30 - 100分),术后增至90.49±8.62分(55 - 100分)(p < 0.001)。Tegner和UCLA评分术后无显著下降(术前分别为4.53和7.14,术后分别为4.1和6.55,p = 0.07和0.09)。术后KOO评分平均为73.52±17.20。术后每周运动次数(2.36±1.6次)无显著减少(术前为2.13次,p = 0.34)。另一方面,活动时长从术前的4.68小时/周±4.25小时显著减少至3.48小时/周(p = 0.04)。术前进行跑步运动的患者中,85%(20例中的17例)能够恢复此项运动。

结论

本研究表明,股骨内侧髁胫股关节炎的膝关节截骨术能使大多数患者恢复如慢跑或滑降滑雪等持续的体力活动。

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