骨关节炎_____骨关节炎;_胫骨高位截骨术;

Koshino胫骨高位截骨结合外固定支架治疗膝内侧髌股型骨关节炎

http://www.100md.com 《中国矫形外科杂志》 2005年第23期

骨关节炎,,骨关节炎;,胫骨高位截骨术;,外固定支架,1材料和方法,2结果,3讨论,参考文献：

     摘要：[目的]介绍Koshino胫骨高位截骨结合外固定支架在膝内侧髌股型骨关节炎治疗中的应用。[方法]自1995年1月~2003年1月，笔者采用Koshino胫骨高位截骨结合外固定支架治疗36例42膝骨关节炎。全部病例均为内侧髌股型骨关节炎。术前术后测量胫股角，关节功能评估采用日本横滨市立大学膝关节功能评分法。术后2~3周扶拐部分负重，平均10~14周拆除外固定支架。[结果]术后平均随访(182±67)个月，术后均无伤口感染，关节血肿，关节粘连或骨不连等。但有6例外固定支架钉道感染，有7例轻度深静脉栓塞。术后3~4个月完全恢复步行。膝关节功能评分改变由术前(55±82)分至术后(90±74)分，胫股角由术前(1843±58)°至术后(1705±22)°。[结论]Koshino胫骨高位截骨结合外固定支架是治疗60岁以下膝内侧髌股型骨关节炎的有效方法。

    关键词：骨关节炎; 胫骨高位截骨术; 外固定支架

    Koshino high tibial osteotomy combined with external fixator for therapy of medialpatellar type knee osteoarthritis

    JIANG Yao,SHEN Hao,GU Xinfeng,et al

    Department of Orthopaedics,Shanghai No6 Peoples Hospital,Jiaotong University，Shanghai 200233

    Abstract：[Objective]To introduce application of Koshino high tibial osteotomy combined with external fixator in therapy of medialpatellar type knee osteoarthritis[Method]From Jan1995 to Jan2003,36 patients (42 knees)with osteoarthritis were treated by Koshino high tibial osteotomy combined with external fixatorAccording to classification of Yokohama City University,all the patients were belonged to medialpatellar typeFemorotibial angle was measured before and after surgery and knee function was evaluated by Yokohama City University Knee Function ScorePartial weightbearing with crutches was permited after 2~3 weeksExternal fixator was removed after 10~14 weeks[Result]The mean followup period were(182±67)monthsWound infection,joint hematoma,articular adhesion and nonunion were not found postoperatively,but pin tract infection was found in 6 patients and deep vein embolism was found in 7 patientsFull weightbearing walking was encouraged 3~4 months after surgeryKnee Function Score and Femorotibial angle were(55±82)°and(1843 ±58)°before,and(90±74)°and(1705 ±22)°after surgery,respectively[Conclusion]Koshino high tibial osteotomy combined with external fixator is an effective therapy for the patients suffered from medialpatellar type knee osteoarthritis and who are younger than 60 years ......

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