| 改良胫骨高位截骨联合富血小板血浆治疗中重度膝骨关节炎的临床研究 |
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投稿时间：2023-08-13
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| 作者 | Author | 单位 | Address | E-Mail |
| 李晓敏 |
LI Xiao-min |
北京中医药大学研究生院, 北京 100029
北京中医药大学第三临床医学院, 北京 100029 |
Graduate School of Beijing University of Chinese Medicine, Beijing 100029, China
The Third School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing 100029, China |
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| 田向东 |
TIAN Xiang-dong |
北京中医药大学第三附属医院, 北京 100029 |
The Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China |
C083@bucm.edu.cn |
| 谭冶彤 |
TAN Ye-tong |
北京中医药大学第三附属医院, 北京 100029 |
The Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China |
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| 丁天送 |
DING Tian-song |
北京中医药大学研究生院, 北京 100029
北京中医药大学第三临床医学院, 北京 100029 |
Graduate School of Beijing University of Chinese Medicine, Beijing 100029, China
The Third School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing 100029, China |
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| 期刊信息：《中国骨伤》2025年，第38卷，第4期，第329-335页 |
| DOI：10.12200/j.issn.1003-0034.20230359 |
| 基金项目:北京中医药大学重点攻关项目(编号:2020-JYB-ZDGG-142-5) |
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中文摘要:
目的: 探讨联合改良胫骨高位截骨和富血小板血浆治疗中重度膝骨关节炎(knee osteoarthritis,KOA)的疗效。
方法: 回顾性分析2021年1月至2022年3月治疗的60例中重度KOA炎患者的临床资料。根据治疗方式不同分为观察组和对照组,其中观察组30例,男12例,女18例,年龄51~74(64.37±5.72)岁,病程1~7(3.43±1.41)年,采用改良胫骨高位截骨联合富血小板血浆治疗;对照组30例,男10例,女20例,年龄50~78(64.33±8.18)岁,病程1~7(3.30±1.39)年,采用改良胫骨高位截骨联合透明质酸钠治疗。术前及末次随访时拍摄膝关节X线片,比较下肢力线比率(weight-bearing limb ratio,WBLR)、胫骨近端内侧角(medial proximal tibial angle,MPTA)、股胫角(femoral tibial angle,FTA)以及胫骨后倾角(posterior tibial slope,PTS)的变化情况;于术前及术后1、3、6个月采用疼痛视觉模拟评分(visualanalogue scale,VAS)、Western Ontario and McMaster Universities骨关节炎指数(Western Ontario and McMaster Universi-ties Osteoarthtitis Index,WOMAC)以及Lysholm评分评价患者膝关节疼痛及功能变化。
结果: 术后所有患者伤口Ⅰ期愈合,60例获得随访,时间6~12(8.08±1.75)个月,未发生严重不良事件及并发症。末次随访时,两组WBLR、MPTA以及FTA均较术前明显改善,差异有统计学意义(P<0.05);末次随访时,两组PTS与术前比较,差异无统计学意义(P>0.05)。末次随访时,观察组WBLR、MPTA、FTA以及PTS与对照组比较,差异无统计学意义(P>0.05)。两组VAS、WOMAC以及Lysholm评分均较术前明显改善,差异有统计学意义(P<0.05)。术后1、3、6个月,观察组的VAS、WOM-AC以及Lysholm评分均优于对照组,差异有统计学意义(P<0.05)。
结论: 针对中重度KOA患者,改良胫骨高位截骨能够明显矫正下肢力线,联合富血小板血浆治疗能够进一步显著缓解膝关节疼痛,改善膝关节功能,效果优于联合透明质酸钠。 |
| 【关键词】改良胫骨高位截骨 富血小板血浆 膝骨关节炎 |
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| Clinical study of modified high tibial osteotomy combined with platelet rich plasma in the treatment of moderate to severe knee osteoarthritis |
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ABSTRACT
Objective To evaluate the clinical efficacy of modified high tibial osteotomy combined with platelet-rich plasma in the treatment of moderate to severe knee osteoarthritis.
Methods From January 2021 to March 2022,the clinical data of 60 patients with moderate to severe knee osteoarthritis admitted to the Third Affiliated Hospital of Beijing University of Chinese Medicine were analyzed. Among them,30 patients were treated with modified tibia high osteotomy combined with platelet rich plasma as the observation group,including 12 males and 18 females,aged from 51 to 74 years old,with an average age of (64.37±5.72) years old. The course of disease ranged from 1 to 7 years with an average of (3.43±1.41) years. Thirty patients were treated with modified high tibial osteotomy combined with sodium hyaluronate as control group,including 10 males and 20 females,aged from 50 to 78 years,with an average age of (64.33±8.18) years. The course of disease was 1 to 7 years with an average of (3.30±1.39) years. Knee X rays were taken before surgery and at the last follow up,and the changes of lower limb bearing line ratio (WBLR),proximal medial tibial Angle (MPTA),femoro tibial angle (FTA) and posterior tibial slope (PTS)were compared between the two times. Visual analogue scale (VAS),Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and Lysholm score were used to evaluate knee pain and functional changes before surgery and at 1,3,and 6 months after surgery.
Results The wounds of all patients healed in stage I after surgery. All 60 patients completed treatment and follow up,with an average follow up duration of (8.08±1.75) months,ranged from 6 to 12 months. No serious adverse events or complications occurred. At the last follow up,WBLR,MPTA and FTA were significantly improved in both groups (P<0.05). At the last follow up,there was no significant difference in PTS between the two groups compared with pre operation (P>0.05). At the last follow up,there were no significant differences in WBLR,MPTA,FTA and PTS between the observation group and the control group (P>0.05). The VAS scores,WOMAC scores and Lysholm scores of both groups were significantly Modified with time after operation (P<0.05). At 1,3 and 6 months after operation,VAS score,WOMAC score and Lysholm score of the observation group were significantly better than those of the control group,with statistical significance (P<0.05).
Conclusion For patients with moderate and severe knee osteoarthritis,modified high tibial osteotomy can significantly correct lower limb alignment,and combined with platelet rich plasma therapy can further significantly relieve knee pain and improve knee function,the effect is better than combined with sodium hyaluronate. |
| KEY WORDS Modified high tibial osteotomy Platelet rich plasma Knee osteoarthritis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李晓敏,田向东,谭冶彤,丁天送.改良胫骨高位截骨联合富血小板血浆治疗中重度膝骨关节炎的临床研究[J].中国骨伤,2025,38(4):329~335 |
| 英文格式: | LI Xiao-min,TIAN Xiang-dong,TAN Ye-tong,DING Tian-song.Clinical study of modified high tibial osteotomy combined with platelet rich plasma in the treatment of moderate to severe knee osteoarthritis[J].zhongguo gu shang / China J Orthop Trauma ,2025,38(4):329~335 |
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