摘要目的 探讨胫骨高位截骨结合膝关节镜下微骨折术治疗膝内侧骨关节炎的早期疗效。方法 2018年8月至2020年8月,采用胫骨高位截骨术及关节镜下微骨折术治疗膝内侧间室骨关节炎共12例,男5例,女7例,年龄49~66岁,平均(53.0±0.8)岁。术前行膝关节磁共振均提示内侧胫骨平台软骨面损伤。先采用关节镜下清理+微骨折术,再行胫骨高位截骨术(均为单侧手术)。所有患者均随访半年以上,进行美国特种外科医院(hospital for special surgery,HSS)膝关节评分,测量术前、术后胫股角(femoral tibia angle,FTA)。结果 全部患者获得随访,随访6~24个月,平均(8.0±0.4)个月。均未发生术中骨折、术后感染、骨筋膜室综合征、腓总神经损伤等并发症。相较术前,患者膝关节疼痛症状均有不同程度改善,截骨面均能完全愈合。FTA角度最大矫正31°,最小矫正16°,平均矫正(21±3)°。术前HSS膝关节评分64~76分,平均(72.1±4.3)分。术后6个月患者HSS膝关节功能评分75~84分,平均(80.1±2.1)分,与术前比较,差异有统计学意义。结论 胫骨高位截骨结合膝关节镜下微骨折术治疗膝内侧骨关节炎早期疗效良好,值得临床上推广应用,但远期疗效有待进一步观察。
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