微创截骨手术方案对内侧间室膝关节骨关节炎患者的疗效及满意度的影响

Influence of minimally invasive osteotomy on clinical efficacy and satisfaction of patients with medial compartment knee osteoarthritis

摘要:

摘要：目的 探讨微创截骨手术方案对内侧间室膝关节骨关节炎（KOA）患者疗效及满意度的影响。方法 研究对象选取该院2016年1月－2017年6月收治的内侧间室KOA患者共140例，以随机数字表法分为对照组（70例）和试验组（70例），分别采用常规截骨手术和关节镜下截骨手术治疗；比较两组术后满意度、手术前后内侧间隙、外翻角、WOMAC评分、Lysholm评分、血清基质金属蛋白酶-1（MMP-1）、基质金属蛋白酶-3（MMP-3）水平及术后并发症发生率。结果 两组术后满意度比较，差异无统计学意义（P >0.05）；两组术后内侧间隙和外翻角比较，差异无统计学意义（P >0.05）；试验组术后WOMAC和Lysholm评分均明显优于对照组和术前（P <0.05）；试验组术后血清MMP-1和MMP-3水平均明显低于对照组和术前（P <0.05）；同时两组早期膝关节无力发生率比较，差异无统计学意义（P >0.05）。结论 微创截骨手术方案治疗内侧间室KOA能够有效缓解相关症状，改善肢体活动功能，且有助于降低血清MMPs水平，价值优于常规截骨手术方案。

Abstract:

Abstract: Objective To investigate the influence of minimally invasive osteotomy on clinical efficacy and satisfaction of patients with medial compartment knee osteoarthritis (KOA). Methods 140 patients with medial compartment KOA were chosen from January 2016 to June 2017 and randomly divided into two groups including control group (70 patients) with conventional osteotomy and experiment group (70 patients) with minimally invasive osteotomy; and the postoperative satisfaction, the medial space, valgus angle, WOMAC score, Lysholm score and the levels of serum MMP-1, MMP-3 before and after operation and postoperative complications incidence of the both two groups were compared. Results There was no significant difference in the postoperative satisfaction between the two groups (P > 0.05). There was no significant difference in the medial space and valgus angle between the two groups (P > 0.05). The WOMAC score and Lysholm score after operation of experiment group were significantly better than that in control group and before operation (P < 0.05). The levels of serum MMP-1, MMP-3 after operation of experiment group were significantly lower than that in control group and before operation (P < 0.05). There was no significant difference in the incidence of knee weakness in early stage between 2 groups (P > 0.05). Conclusion Compared with conventional osteotomy, minimally invasive osteotomy in the treatment of patients with medial compartment KOA can efficiently relieve related symptoms and improve limb movement function and be helpful to reduce serum MMPs levels.