Parc de Salut Mar, Orthopaedic department, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
Consorci Sanitari de l'Anoia, Barcelona, Spain.
Orthop Traumatol Surg Res. 2018 Apr;104(2):193-196. doi: 10.1016/j.otsr.2017.11.020. Epub 2018 Jan 31.
The aim of this study was to assess the utility of pressure algometry (PA) to measure pain relief in the medial part of the knee after a closing-wedge high tibial osteotomy (CWHTO).
Prospective study including 44 CWHTO. Pain relief was evaluated with the visual analogue scale (VAS) and PA, a radiological study was done and a functional assessment was carried out with the KSS preoperatively, at 6-months and at 1-year after the surgery. PA was applied to the medial and lateral part of the knee and to the infra-clavicular fossa as a control point.
The mechanical femorotibial angle was changed from 172.2° (SD2.2) to 180.6° (SD2.6) (p=0.00). KSS Knee improved from 53.4 (SD11.2) to 92.8 (SD7.3) (p=0.00), KSS Function from 69.4 (SD9.3) to 93.1 (SD8) (p=0.00). The VAS went from 6.84 (SD1.5) to 2.5 (SD2.1) (p=0.00) at the 1-year follow-up. The pressure pain threshold (PPT), measured with PA in the medial part of the knee also improved from 348.8kPa (SD159.3) to 447.1kPa (SD218.8) (p=0.01). However, the PPT in the lateral part of the knee and in the sub-clavicular fossa remained the same from the preoperative period to 6-months and 1-year, postoperatively. Neither were there any differences between the 6-month and 1-year postoperative values in terms of the different functional, radiological and pain relief obtained.
The pain relief obtained after a CWHTO in the medial part of the knee can be measured by using PA. Furthermore, the functional and pain improvement obtained at 1-year follow-up is no better than those obtained at 6-months postoperatively.
本研究旨在评估压力压痛测定法(PA)在测量闭楔形胫骨高位截骨术(CWHTO)后膝关节内侧疼痛缓解程度的应用价值。
前瞻性研究共纳入 44 例 CWHTO 患者。采用视觉模拟评分(VAS)和 PA 评估疼痛缓解程度,进行放射学研究,并在术前、术后 6 个月和 1 年进行膝关节功能评估(KSS)。PA 应用于膝关节内侧和外侧以及锁骨下窝作为对照点。
机械性股骨胫骨角从 172.2°(SD2.2)变为 180.6°(SD2.6)(p=0.00)。KSS 膝关节评分从 53.4(SD11.2)提高到 92.8(SD7.3)(p=0.00),KSS 功能评分从 69.4(SD9.3)提高到 93.1(SD8)(p=0.00)。VAS 在 1 年随访时从 6.84(SD1.5)降至 2.5(SD2.1)(p=0.00)。膝关节内侧的压力疼痛阈值(PPT)也从 348.8kPa(SD159.3)提高到 447.1kPa(SD218.8)(p=0.01)。然而,膝关节外侧和锁骨下窝的 PPT 在术前、术后 6 个月和 1 年均无变化。在获得的不同功能、放射学和疼痛缓解方面,6 个月和 1 年的术后值之间也没有差异。
CWHTO 后膝关节内侧的疼痛缓解程度可以通过 PA 来测量。此外,在 1 年随访时获得的功能和疼痛改善并不优于术后 6 个月时的改善。