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压力测痛法是一种评估闭楔形胫骨高位截骨术后膝关节疼痛缓解的优秀工具。

Pressure algometry is an excellent tool to measure knee pain relief after a closing-wedge high tibial osteotomy.

机构信息

Parc de Salut Mar, Orthopaedic department, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.

Consorci Sanitari de l'Anoia, Barcelona, Spain.

出版信息

Orthop Traumatol Surg Res. 2018 Apr;104(2):193-196. doi: 10.1016/j.otsr.2017.11.020. Epub 2018 Jan 31.

Abstract

PURPOSE

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).

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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