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[1]高文香,王明君,李曉峰,等.改良髕骨外側(cè)關(guān)節(jié)面部分切除術(shù)治療嚴(yán)重髕股關(guān)節(jié)骨關(guān)節(jié)炎的臨床研究[J].中醫(yī)正骨,2017,29(03):6-9,19.
 GAO Wenxiang,WANG Mingjun,LI Xiaofeng,et al.Clinical study on improved partial lateral patellar facetectomy for treatment of severe patellofemoral joint osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(03):6-9,19.
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改良髕骨外側(cè)關(guān)節(jié)面部分切除術(shù)治療嚴(yán)重髕股關(guān)節(jié)骨關(guān)節(jié)炎的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第29卷
期數(shù):
2017年03期
頁(yè)碼:
6-9,19
欄目:
臨床研究
出版日期:
2017-03-20

文章信息/Info

Title:
Clinical study on improved partial lateral patellar facetectomy for treatment of severe patellofemoral joint osteoarthritis
作者:
高文香王明君李曉峰李鵬郭明偉鄒春雨郝軍
河南省洛陽(yáng)正骨醫(yī)院/河南省骨科醫(yī)院,河南 鄭州 450016
Author(s):
GAO WenxiangWANG MingjunLI XiaofengLI PengGUO MingweiZOU ChunyuHAO Jun
Luoyang Orthopedic-Traumatological Hospital,Zhengzhou 450016,Henan,China
關(guān)鍵詞:
骨關(guān)節(jié)炎 髕股關(guān)節(jié) 關(guān)節(jié)成形術(shù)
Keywords:
osteoarthritisknee patellofemoral joint arthroplasty
摘要:
目的:探討改良髕骨外側(cè)關(guān)節(jié)面部分切除術(shù)治療嚴(yán)重髕股關(guān)節(jié)骨關(guān)節(jié)炎的臨床療效。方法:選擇改良Iwano分期Ⅲ期髕股關(guān)節(jié)骨關(guān)節(jié)炎患者60例,按就診順序采用隨機(jī)數(shù)字表隨機(jī)分為觀察組和對(duì)照組,每組30例。觀察組采用改良髕骨外側(cè)關(guān)節(jié)面部分切除術(shù)治療,對(duì)照組采用雙醋瑞因膠囊口服聯(lián)合透明質(zhì)酸鈉注射液膝關(guān)節(jié)腔內(nèi)注射治療。分別于治療前和末次隨訪時(shí),采用Merchant法在髕骨軸位X線片上測(cè)量髕股適合角判定髕股關(guān)節(jié)力線情況,并分別采用髕骨改良Kujala評(píng)分和美國(guó)膝關(guān)節(jié)協(xié)會(huì)評(píng)分(knee society score,KSS)評(píng)價(jià)髕股關(guān)節(jié)和膝關(guān)節(jié)整體功能。結(jié)果:60例患者均獲隨訪,隨訪時(shí)間20~30個(gè)月,中位數(shù)24個(gè)月。治療前2組患者髕股適合角、髕骨改良Kujala評(píng)分、膝關(guān)節(jié)KSS評(píng)分比較,組間差異均無(wú)統(tǒng)計(jì)學(xué)意義[23.07°±10.30°,23.60°±10.05°,t=0.203,P=0.840;(15.93±3.32)分,(14.50±2.87)分,t=1.788,P=0.079;(110.40±15.18)分,(109.13±16.05)分,t=0.314,P=0.755]; 末次隨訪時(shí),觀察組髕股適合角優(yōu)于對(duì)照組,髕骨改良Kujala評(píng)分、膝關(guān)節(jié)KSS評(píng)分高于對(duì)照組
[11.91°±7.36°,24.13°±9.71°,t=5.495,P=0.000;(32.03±4.20)分,(18.13±7.79)分,t=8.604,P=0.000;(156.77±9.30)分,(115.00±20.25)分,t=10.266,P=0.000]。結(jié)論:與雙醋瑞因膠囊口服聯(lián)合透明質(zhì)酸鈉注射液膝關(guān)節(jié)腔內(nèi)注射相比,改良髕骨外側(cè)關(guān)節(jié)面部分切除術(shù)治療嚴(yán)重髕股關(guān)節(jié)骨關(guān)節(jié)炎,在恢復(fù)髕股關(guān)節(jié)力線、改善髕股關(guān)節(jié)和膝關(guān)節(jié)整體功能方面療效更佳。
Abstract:
ABSTRACT Objective:To explore the clinical curative effects of improved partial lateral patellar facetectomy for treatment of severe patellofemoral joint osteoarthritis.Methods:Sixty patients with improved Iwano phaseⅢpatellofemoral joint osteoarthritis were randomly divided into observation group and control group according to visit sequence by using random digits table,30 cases in each group.The patients in observation group were treated with improved partial lateral patellar facetectomy,while the patients in control group were treated with oral application of diacerein capsules and intraarticular injection of sodium hyaluronate.The patellofemoral congruence angles(CA)were measured on the patellar transverse x-ray films by using Merchant method for assessing the patellofemoral joint force-lines before treatment and at last follow-up respectively,and the patellofemoral joint function and total knee joint function were evaluated by using modified patellar Kujala score and American knee society score(KSS)respectively.Results:All patients in the 2 groups were followed up for 20-30 months with a median of 24 months.There was no statistical difference in the patellofemoral CA,modified patellar Kujala scores and knee KSS scores between the 2 groups before treatment([23.07+/-10.30 vs 23.60+/-10.05 degrees,t=0.203,P=0.840; 15.93+/-3.32 vs 14.50+/-2.87 points,t=1.788,P=0.079; 110.40+/-15.18 vs 109.13+/-16.05 points,t=0.314,P=0.755].The patellofemoral CA were smaller and the modified patellar Kujala scores and knee KSS scores were higher in observation group compared to control group at the last follow-up(11.91+/-7.36 vs 24.13+/-9.71 degrees,t=5.495,P=0.000; 32.03+/-4.20 vs 18.13+/-7.79 points,t=8.604,P=0.000; 156.77+/-9.30 vs 115.00+/-20.25 points,t=10.266,P=0.000).Conclusion:Better patellofemoral joint force-line and patellofemoral joint function and total knee joint function can be obtained in the treatment of severe patellofemoral joint osteoarthritis by using improved partial lateral patellar facetectomy compared to combination therapy of oral application of diacerein capsules and intraarticular injection of sodium hyaluronate.

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備注/Memo

備注/Memo:
基金項(xiàng)目:河南省中醫(yī)藥科學(xué)研究專項(xiàng)課題(2013ZY02030)
更新日期/Last Update: 1900-01-01