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[1]李曉敏,田向東,譚冶彤,等.脛骨結節(jié)遠端單平面截骨治療合并骨質疏松癥的老年膝骨關節(jié)炎[J].中醫(yī)正骨,2023,35(02):66-70,80.
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脛骨結節(jié)遠端單平面截骨治療合并骨質疏松癥的老年膝骨關節(jié)炎()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期數:
2023年02期
頁碼:
66-70,80
欄目:
臨床報道
出版日期:
2023-02-20

文章信息/Info

作者:
李曉敏田向東譚冶彤丁天送
(北京中醫(yī)藥大學第三附屬醫(yī)院,北京 100029)
關鍵詞:
骨關節(jié)炎 骨質疏松 截骨術 老年人
摘要:
目的:觀察脛骨結節(jié)遠端單平面截骨治療合并骨質疏松癥的老年膝骨關節(jié)炎的臨床療效和安全性。方法:2020年6月至2021年6月,采用脛骨結節(jié)遠端單平面截骨治療合并骨質疏松癥的老年膝骨關節(jié)炎患者42例。男15例,女27例; 年齡(67.17±5.11)歲; 左膝24例,右膝18例; 體質量指數(27.70±3.72)kg·m-2; 病程(3.52±1.58)年。所有患者均為原發(fā)性骨質疏松癥(T值≤-2.5)和內側單間室膝骨關節(jié)炎患者,均未見外側間室半月板及軟骨退變; 膝關節(jié)屈曲均>105°,無或僅有輕度的屈曲攣縮畸形。分別于術前及末次隨訪時,在下肢全長正位X線片上測量患者的髖-膝-踝(hip-knee-ankle,HKA)角、脛骨近端內側角(medial proximal tibial angle,MPTA),測量并計算患者的下肢負重力線比率(weight bearing line ratio,WBLR); 在膝關節(jié)側位X線片上測量患者的脛骨后傾角(posterior tibial slope,PTS),測量并計算患者的Caton-Deschamps指數、Blackburne-Peel指數以及Insall-Salvati指數。分別于術前及術后1個月、6個月、12個月時,采用膝關節(jié)疼痛視覺模擬量表(visual analogue scale,VAS)評分評價膝關節(jié)疼痛程度,采用西安大略和麥克馬斯特大學骨關節(jié)炎指數(Western Ontario and McMaster Universities osteoarthritis index,WOMAC)評分和Lysholm膝關節(jié)評分評價膝關節(jié)功能。隨訪觀察并發(fā)癥發(fā)生情況。結果:42例患者均順利完成手術; 均獲隨訪,隨訪時間(13.17±1.38)個月。HKA角,術前172.41°±2.04°、末次隨訪時182.41°±1.55°; MPTA,術前81.21°±1.59°、末次隨訪時92.98°±1.46°; WBLR,術前(17.91±2.56)%、末次隨訪時(62.24±1.33)%; PTS,術前10.41°±1.35°、末次隨訪時10.35°±1.31°; Caton-Deschamps指數,術前1.03±0.14、末次隨訪時1.02±0.14; Blackburne-Peel指數,術前0.99±0.21、末次隨訪時0.98±0.20; Insall-Salvati指數,術前1.14±0.17、末次隨訪時1.13±0.17; 膝關節(jié)疼痛VAS評分,術前(7.74±0.83)分、術后1個月(0.88±0.67)分、術后6個月(0.41±0.54)分、術后12個月(0.12±0.33)分; WOMAC評分,術前(119.14±18.39)分、術后1個月(86.21±2.48)分、術后6個月(72.19±3.54)分、術后12個月(52.81±5.21)分; Lysholm膝關節(jié)評分,術前(48.41±4.28)分、術后1個月(78.93±3.18)分、術后6個月(90.10±1.96)分、術后12個月(92.95±1.71)分。所有患者均未發(fā)生截骨區(qū)骨不愈合或延遲愈合等并發(fā)癥。結論:采用脛骨結節(jié)遠端單平面截骨治療合并骨質疏松癥的老年膝骨關節(jié)炎,能矯正下肢力線、維持髕骨高度、緩解膝關節(jié)疼痛、改善膝關節(jié)功能,且并發(fā)癥少。

參考文獻/References:

[1] ZHANG W,MOSKOWITZ R W,NUKI G,et al.OARSI re-commendations for the management of hip and knee osteoarthritis,part I:critical appraisal of existing treatment guidelines and systematic review of current research evidence[J].Osteoarthritis Cartilage,2007,15(9):981-1000.
[2] JEONG B O,KIM T Y,BAEK J H,et al.Following the correction of varus deformity of the knee through total knee arthroplasty,significant compensatory changes occur not only at the ankle and subtalar joint,but also at the foot[J].Knee Surg Sports Traumatol Arthrosc,2018,26(11):3230-3237.
[3] SHARMA L,SONG J,FELSON D T,et al.The role of knee alignment in disease progression and functional decline in knee osteoarthritis[J].JAMA,2001,286(2):188-195.
[4] TORRES-CLARAMUNT R,PELFORT X,HINAREJOS P,et al.Pressure algometry is an excellent tool to measure knee pain relief after a closing-wedge high tibial osteotomy[J].Orthop Traumatol Surg Res,2018,104(2):193-196.
[5] 董天華,李石倫,于沂陽,等.不均勻沉降理論新進展[J].河北醫(yī)科大學學報,2016,37(11):1354.
[6] SCHUSTER P,RICHTER J.Editorial commentary:high tibial osteotomy is effective,even in patients with severe osteoarthritis:contradiction of another dogma from the past[J].Arthroscopy,2021,37(2):645-646.
[7] 任富繼,黃競敏,陳嘯,等.中度與重度內側單間室骨關節(jié)炎內側開放楔形脛骨高位截骨術的療效比較[J].中華骨科雜志,2022,42(9):545-554.
[8] 韓昶曉,田向東,王劍,等.脛骨結節(jié)遠端單平面截骨術對髕骨高度的影響[J].中華關節(jié)外科雜志(電子版),2020,14(5):559-564.
[9] LONGINO P D,BIRMINGHAM T B,SCHULTZ W J,et al.Combined tibial tubercle osteotomy with medial opening wedge high tibial osteotomy minimizes changes in patellar height:a prospective cohort study with historical controls[J].Am J Sports Med,2013,41(12):2849-2857.
[10] 王江靜,劉國強,季文輝.基于生物信息學探討膝骨關節(jié)炎與骨質疏松間的作用機制[J].解放軍醫(yī)藥雜志,2022,34(2):60-65.
[11] 吳昊,王立新,程兆明,等.骨質疏松對手術治療女性Colles骨折預后影響的臨床研究[J].中華全科醫(yī)學,2012,10(11):1696-1698.
[12] KUBOTA M,OHNO R,SATO T,et al.The medial proximal tibial angle accurately corrects the limb alignment in open-wedge high tibial osteotomy[J].Knee Surg Sports Traumatol Arthrosc,2019,27(8):2410-2416.
[13] 程靜波,李超,馮明利.開放式楔形脛骨高位截骨術對髕骨位置的影響[J].中國骨與關節(jié)損傷雜志,2019,34(4):443-445.
[14] SONG I H,SONG E K,SEO H Y,et al.Patellofemoral alignment and anterior knee pain after closing- and opening-wedge valgus high tibial osteotomy[J].Arthroscopy,2012,28(8):1087-1093.
[15] GOSHIMA K,SAWAGUCHI T,SHIGEMOTO K,et al.Patellofemoral osteoarthritis progression and alignment changes after open-wedge high tibial osteotomy do not affect clinical outcomes at midterm follow-up[J].Arthroscopy,2017,33(10):1832-1839.
[16] 蔣協遠,王大偉.骨科臨床療效評價標準[M].北京:人民衛(wèi)生出版社,2005:123-124.
[17] FERREIRA C D B,DIBAI-FILHOA V,ALMEIDA D O D S,et al.Structural validity of the Brazilian version of the Western and McMaster Universities osteoarthritis index among patients with knee osteoarthritis[J].Sao Paulo Med J,2020,138(5):400-406.
[18] 劉云鵬,劉沂.骨與關節(jié)損傷和疾病的診斷分類及功能評定標準[M].北京:清華大學出版社,2002:230-231.
[19] BULTINK I E,LEMS W F.Osteoarthritis and osteoporosis:what is the overlap?[J].Curr Rheumatol Rep,2013,15(5):328.
[20] GEUSENS P P,VAN DEN BERGH J P.Osteoporosis and osteoarthritis:shared mechanisms and epidemiology[J].Curr Opin Rheumatol,2016,28(2):97-103.
[21] 張程,吳忠書,李子祺,等.膝骨關節(jié)炎與骨質疏松癥的相關性研究進展[J].中國骨質疏松雜志,2021,27(4):618-624.
[22] TROUVIN A P,GOËB V.Receptor activator of nuclear factor-kappaB ligand and osteoprotegerin:maintaining the balance to prevent bone loss[J].Clin Interv Aging,2010,5:345-354.
[23] CERVELLATI C,BONACCORSI G,CREMONINI E,et al.Bone mass density selectively correlates with serum markers of oxidative damage in post-menopausal women[J].Clin Chem Lab Med,2013,51(2):333-338.
[24] BELLIDO M,LUGO L,ROMAN-BLAS J A,et al.Improving subchondral bone integrity reduces progression of cartilage damage in experimental osteoarthritis preceded by osteoporosis[J].Osteoarthritis Cartilage,2011,19(10):1228-1236.
[25] ROBINSON W H,LEPUS C M,WANG Q,et al.Low-grade inflammation as a key mediator of the pathogenesis of osteoarthritis[J].Nat Rev Rheumatol,2016,12(10):580-592.
[26] 馬曉菊,劉峰,凌斌,等.口服氨基葡萄糖硫酸軟骨素結合骨健康操對絕經后女性骨關節(jié)健康影響的現場試驗[J].中國慢性病預防與控制,2019,27(3):222-225.
[27] 韓小平,王璽喆,張杰,等.開放楔形脛骨高位截骨術治療內翻型膝骨關節(jié)炎的短期療效分析[J].實用骨科雜志,2021,27(10):886-890.
[28] 李珂,孫鳳龍,王宏慶,等.改良單平面脛骨高位截骨術治療膝關節(jié)骨關節(jié)炎的早期臨床研究[J].中華骨與關節(jié)外科雜志,2020,13(9):729-735.
[29] 張英澤,李存祥,李冀東,等.不均勻沉降在膝關節(jié)退變及內翻過程中機制的研究[J].河北醫(yī)科大學學報,2014,35(2):218-219.
[30] FUJISAWA Y,MASUHARA K,SHIOMI S.The effect of high tibial osteotomy on osteoarthritis of the knee.An arthroscopic study of 54 knee joints[J].Orthop Clin North Am,1979,10(3):585-608.
[31] 李軍,梁帥,姚運峰,等.懸空膝關節(jié)對內側開放楔形脛骨高位截骨術后脛骨平臺后傾角的影響[J].中國修復重建外科雜志,2022,36(6):703-707.
[32] 周觀明,劉效仿,管明強,等.改良內側開放式脛骨高位截骨術治療膝內側間室骨性關節(jié)炎[J].組織工程與重建外科雜志,2021,17(1):54-56.
(收稿日期:2022-10-01 本文編輯:時紅磊)

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備注/Memo

備注/Memo:
基金項目:北京中醫(yī)藥大學重點攻關項目(2020-JYB-ZDGG-142-5) 通訊作者:田向東 E-mail:[email protected]
更新日期/Last Update: 1900-01-01