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腓骨近端部分切除对膝关节内侧间室骨关节炎的影响。

Effects of proximal fibular partial excision on medial compartment knee osteoarthritis.

作者信息

Atlıhan Doğan, Günaydın Fatih, Muslu Duran Can

机构信息

Department of Orthopaedic Surgery, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey.

Department of Orthopaedic Surgery, Mersin Training and Research State HospitalKorukent MahMersin Entegre Sağlık Kampüsü, 96015 Sok, 33240, Toroslar, Mersin, Turkey.

出版信息

Int Orthop. 2022 Oct;46(10):2251-2256. doi: 10.1007/s00264-022-05471-5. Epub 2022 Jun 14.

Abstract

BACKGROUND

This study aimed to investigate the clinical and radiological progression of the patients who underwent proximal fibular partial excision (PFPE) for medial compartment knee osteoarthritis.

METHODS

Patients with medial compartment knee osteoarthritis who did not benefit from conservative treatment and accepted the PFPE surgery were involved in this study. Patients with traumatic arthritis, inflammatory arthritis, previous lower extremity fractures, valgus malalignment of the knee, and infection at the planned surgical site, however, were kept apart. Patients were assessed both clinically by Visual Analog Scale (VAS) and American Knee Society Score (AKSS), radiologically by Kellgren Lawrence classification, tibiofemoral angle, and joint-line convergence angle (JLCA). The patients were systematically assessed especially in the sixth month and first, second, and third years of the post-operative period.

RESULTS

A total of 35 patients (mean age: 56.5, min: 45, max: 79) were involved in this study. The mean follow-up period was 22.4 months (min: 6, max: 36). It has been observed that: Statistically significant decrease in VAS and increase in AKSS after PFPE (p < 0.001) No statistically significant improvement in preoperative and postoperative tibiofemoral angle and JLCA measurements CONCLUSIONS: The PFPE is a safe and effective surgical treatment for pain relief and functional improvement in medial compartment knee osteoarthritis. More studies are needed on its mechanism of action, long-term effects, and comparison with other treatment options.

摘要

背景

本研究旨在调查因膝关节内侧间室骨关节炎接受腓骨近端部分切除术(PFPE)患者的临床和影像学进展情况。

方法

本研究纳入了膝关节内侧间室骨关节炎且保守治疗无效并接受PFPE手术的患者。然而,排除了患有创伤性关节炎、炎性关节炎、既往有下肢骨折、膝关节外翻畸形以及计划手术部位感染的患者。通过视觉模拟评分法(VAS)和美国膝关节协会评分(AKSS)对患者进行临床评估,通过凯尔格伦-劳伦斯分级、胫股角和关节线汇聚角(JLCA)进行影像学评估。对患者在术后第六个月以及第一、第二和第三年进行系统评估。

结果

本研究共纳入35例患者(平均年龄:56.5岁,最小45岁,最大79岁)。平均随访期为22.4个月(最小6个月,最大36个月)。观察到:PFPE术后VAS有统计学意义的下降,AKSS有统计学意义的升高(p < 0.001);术前和术后胫股角及JLCA测量值无统计学意义的改善。

结论

PFPE是一种安全有效的手术治疗方法,可缓解膝关节内侧间室骨关节炎的疼痛并改善功能。需要对其作用机制、长期效果以及与其他治疗选择的比较进行更多研究。

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