Faculty of Medicine, Department of Orthopaedics and Traumatology, Ağrı İbrahim Çeçen University, Ağrı, Türkiye.
Faculty of Medicine, Department of Orthopaedics and Traumatology, Atatürk University, Erzurum, Türkiye.
J Orthop Surg Res. 2024 Sep 28;19(1):601. doi: 10.1186/s13018-024-05095-y.
This study aimed to compare the effects of microfracture (MF) versus intra-articular hyaluronic acid (HA) + oral glucosamine and chondroitin sulfate (GC) in addition to MF in patients with osteoarthritic knees who underwent medial open wedge high tibial osteotomy (MOWHTO) after an average follow-up of five years.
The study was designed retrospectively and included patients who underwent MOWHTO due to gonarthrosis, the MF method performed on these patients, and HA + GC treatments applied in addition to MF. Three groups consisting of 79 patients were formed: only HTO (Group 1), HTO + MF (Group 2), and HTO + MF + HA + GC (Group 3). The groups were compared using knee injury and osteoarthritis outcome score (KOOS), visual analog scale (VAS) for pain, and range of motion (ROM). The associations between the degree of correction and function and pain were evaluated. Additionally, the KOOS subparameters were compared between the groups.
There were significant improvements in the postoperative KOOS and VAS scores in all three groups (p < 0.05). However, the ROM did not improve in Group 1. There was no significant difference in the postoperative KOOS, VAS, or ROM values between Groups 2 and 3, but these values were significantly better in Groups 2 and 3 than in Group 1 (p < 0.05). When the degree of correction increased, there were no significant positive changes in the postoperative KOOS or VAS score in Group 1, unlike in the other two groups (p < 0.05). In corrections of ≥ 10°, while there was no significant difference in the postoperative KOOS or VAS score between Groups 2 and 3, these parameters significantly improved in these two groups compared to Group 1 (p < 0.05). Among the KOOS subparameters, pain and activities of daily living scores were greater in Groups 2 and 3 than in Group 1 (p < 0.05).
In MOWHTO, MF is a sufficient treatment method that improves the patient's clinical condition without requiring additional treatments such as HA and GC.
III, retrospective cohort study.
本研究旨在比较关节镜下微骨折术（MF）与关节内透明质酸（HA）+口服氨基葡萄糖和硫酸软骨素（GC）联合 MF 治疗对行内侧开放楔形胫骨高位截骨术（MOWHTO）的膝关节骨关节炎患者的疗效，平均随访 5 年后进行评估。
本研究为回顾性设计，纳入因膝关节骨关节炎行 MOWHTO 的患者，对这些患者行 MF 治疗，并在 MF 治疗的基础上加用 HA+GC 治疗。共纳入 79 例患者，分为 3 组：仅行 HTO（A 组）、行 HTO+MF（B 组）、行 HTO+MF+HA+GC（C 组）。通过膝关节损伤和骨关节炎评分（KOOS）、疼痛视觉模拟量表（VAS）和关节活动度（ROM）对各组进行比较。评估了校正程度与功能和疼痛之间的关系。同时，对各组的 KOOS 亚组参数进行了比较。
三组患者术后 KOOS 和 VAS 评分均显著改善（p<0.05）。但 A 组术后 ROM 无改善。B 组和 C 组术后 KOOS、VAS 和 ROM 值无显著差异，但 B 组和 C 组明显优于 A 组（p<0.05）。A 组中，校正程度增加时，术后 KOOS 或 VAS 评分无显著变化，而其他两组则有（p<0.05）。在矫正角度≥10°时，B 组和 C 组之间术后 KOOS 或 VAS 评分无显著差异，但与 A 组相比，这两组的参数明显改善（p<0.05）。在 KOOS 亚组中，B 组和 C 组的疼痛和日常生活活动评分明显高于 A 组（p<0.05）。
在 MOWHTO 中，MF 是一种有效的治疗方法，可改善患者的临床状况，无需额外的 HA 和 GC 等治疗。
III，回顾性队列研究。
