【摘要】 目的回顾性研究探讨胫骨高位截骨联合膝关节镜下外侧支持带松解及清理术的临床疗效。方法将68例(85膝)膝关节疾患分成A组和B组(n=34),A组施行胫骨高位截骨联合膝关节镜下清理术;B组施行胫骨高位截骨联合膝关节镜下清理及外侧支持带松解术。然后对A组和B组进行比较及B组术前和术后进行比较。结果术后测的数据均为随访15个月以上测得,髌骨中心的外侧位移A组为(6.1±2.3)mm,B组(1.2±0.8)mm髌股适合角(CA)A组术后(12.3±7.2)°,B组术后(4.2±2.5)°髌骨倾斜角(PTA)A组术后(11.4±3.6)°,B组术后(3.3±2.1)°。HSS膝关节评分A组术前(42±6.0)分,术后(73±12.3)分,B组术前(40±4.5)分,术后(85±9.0)分,结果术后A组和B组存在明显差异(P<0.05)。B组术前和术后存在明显差异(P<0.01)。结论胫骨高位截骨联合膝关节镜下外侧支持带松解及清理外术明显优于胫骨高位截骨联合膝关节镜下清理术式,它不仅解决了胫股关节的问题同时解决了髌股关节的问题,消除了髌股关节由于胫骨高位截骨而随之产生力线异常,对提高近期及远期疗效有积极的临床意义。更多还原

【Abstract】 Objective To retrospectively investigate and evaluate the clinical result of high tibial osteotomy with arthroscopic lateral retinacular release and debridement. Methods The 68 patients (85 knees) were retrospectively studied. From these patients, two matched groups (group A and group B) of 34 patients each were formed. In group A, high tibial osteotomy with arthroscopic debridement was used while in group B, arthroscopic lateral retinacular release was added after high tibial osteotomy with arthroscopic debridement. The result of group A and group B was compared as well as the preoperative parameters and postoperative parameters in group B. Results The postoperative data were gained after 15 months follow-up. The center of patella laterally translating: group A( 6.1±2.3)mm, group B(1.2±0.8) mm. CA: group A, postoperative (12.3±7.2)°. group B,postopertive (4.2±2.5)°.PTA: group A,postopertive(11.4±3.6)°. group B, postoperative(3.3± 2.1)°.HSS Knee score: group A preoperative(42±6.0) points, postoperative(73±12.3) points group B preoperative (40±4.5) points, postoperative (85±9.0) points. group B had statistically significant difference from group A in postoperative value. group B was better than group A (P<0.05). group B had statistically significant difference in preoperative and postoperative value (P<0.01). Conclusion The technique of high tibial osteotomy with arthroscopic lateral retinacular release and debridement was better than high tibial osteotomy with arthroscopic debridement in the clinical and radiographic evaluations. This combination not only solves the problem of femoral-tibial joint and patellalfemoral joint but also eliminates the risk of abnormal alignment of the patellalfemoral joint because of high tibial osteotomy. It may be far better in terms of escalating the clinical the shortand longterm efficacy.更多还原