Recent Clinical Efficacy Of Minimally Invasive Knee Joint Cleaning Combined With Non-uniform Settlement Theory Of Fibula Proximal Osteotomy In The Treatment Of Moderate Varus Knee Osteoarthritis(KOA)

Objective To investigate the recent clinical efficacy of minimally invasive knee joint cleaning combined with fibula proximal osteotomy in the treatment of moderate varus KO A.Methods A retrospective analysis was performed on 42 patients diagnosed with moderate varus KOA in our hospital from September 2016 to September 2018,who were randomly divided into two groups.The observation group received arthroscopic debridement combined with fibula proximal osteotomy,and the control group received minimally invasive knee cavity debridement.After the operation,all patients were injected with "cocktails" in the articular cavity(contains sodium hyaluronate injection 2ml+triamcinolone acetonide injection 2ml+ropivacaine mesylate injection 2ml),after the end of anesthesia,take ankle pump exercise,quadriceps contraction and other functional exercise,after 24 hours of cold compress,they began to exercise the flexion and extension function of the knee joint,48 hours after surgery,they could walk on crutches and avoid strenuous exercise within 1 week.Records of two groups of patients with preoperative and postoperative 1 week,1 month,3 months,6 months the visual analog pain score(VAS)and the Lysholm knee rating,compared two groups of patients at the same time the ratings data.At the same time,record the data changes of the femoral tibial angle,knee varus angle,the distance between the medial and lateral spaces of the knee joint on the X-ray in the preoperative and 6 months after the surgery in the two groups.Results 1.Preoperative general data of the two groups of patients were compared:gender,age,side,time,Kellgren-Lawrence grading,VAS score and Lysholm score.The difference showed no statistical significance(P>0.05),indicating that the preoperative data of the two groups showed no difference.2.The VAS scores of the observation group at 1 week,1 month,3 months and 6 months after surgery were lower than those of the control group.The Lysholm score of the knee joint was higher than that of the control group during the same period(P<0.05),and the difference was statistically significant,suggesting that the effect of the observation group was better than that of the control group during the same period.3.In the control group,the angle of femor-tibial,the angle of knee varus and the distance between the medial and lateral spaces of the knee joint had no significant change before and after the surgery(P<0.05),and in the observation group,the inside clearance and the femor-tibial angle were increasing,the angle of knee varus were decreased except the lateral clearance change is not obvious(P<0.05),It was suggested that the postoperative lower limb strength line in the observation group was better than that in the control group.Conclusion:In the treatment of moderate varus KOA,minimally invasive cleaning of the knee joint cavity combined with fibula proximal osteotomy can not only improve the internal environment of the joint cavity,but also can correct the force line of varus to a certain extent and slow down the speed of joint lesions,the recent clinical effect is obvious.In addition,it has the advantages of small trauma,quick recovery,low hospitalization cost,few complications and low technical difficulty.It is a good choice for knee-preserving surgery in clinic.