| ObjectiveTo compare and analyze the clinical efficacy of limited knee arthroscopy and limited arthroscopic knee arthroplasty combined with high fibula osteotomy for medial compartment knee osteoarthritis.MethodsFrom August 2015 to December 2016,32 patients(32 knees)with medial compartment knee osteoarthritis who were admitted to the Yongzhou Clinical College Affiliated to Nanhua University were selected for the study.Before the admission,1-32 were serially arranged,and were divided into a control group and an experimental group according to a random number table.The control group only had knee arthroscopic limited debridement.The experimental group underwent limited knee arthroscopic debridement combined with high tibial osteotomy.According to the order of the patients admitted to the hospital,the number assigned randomly before surgery was compared with the corresponding surgery.The experimental group included 16 males,4 males and 12 females;the average age was(60.3±6.5)years.In the control group,there were 16 males,3 males and 13 females;the average age was(58.8±5.9)years.There was no significant difference between the two groups in the preoperative general data(P>0.05).Before admission,knee MRI was performed.Based on MRI findings and physical examination,patients with severe cartilage injury and severe cruciate ligament or meniscal injury were initially excluded.After the initial screening of the two groups of patients,knee arthroscopic exploration was performed to truly evaluate the degeneration of cartilage injuries on the femoral articular surface,the tibial articular surface,and the patellofemoral articular surface.According to the staging history of cartilage damage,patients with cartilage injury more than grade 3 and above,or patients with cruciate ligamentous laxity injury,or severe meniscus injury were all treated with relevant treatment plans and were not included in this study.Subjects were numbered in the order Push forward.Arthroscopic debridement includes debridement of inflammatory synovial tissue,abrasion of hyperplastic spurs,repair of ruptured meniscus,removal of loose bodies,repair of damaged cartilage,and removal of various irritants and effusions from the joint cavity.The experimental group underwent limited arthroscopic debridement while continuing to perform a high tibial osteotomy.The humeral head was marked before surgery.A longitudinal incision of approximately 20 mm long was performed approximately 60-80 mm below the head of the humerus.Approximately 15-20 mm long proximal tibia was closed by bone wax to seal the cut ends of the tibial osteotomy.Comparing Visual Analogue Scale(VAS),Lysholm Knee Score,Preoperative,Postoperative 1 Week,Postoperative 6 Months,Postoperatively,Preoperative,Postoperative 1 Week,Postoperative 6 Months,and Postoperative 1 Year Postoperative Visual Analogue Scale.One-year follow-up of the lower limbs was performed on the affected lower limbs.The ratio of the knee joint gap(medial/lateral space)was measured.The lateral side was the lowest point of the lateral femoral condyle and the lateral tibial plateau,and the medial femoral medial condyle was the lowest.The point and the medial tibial plateau were obtained.The operative complications were recorded.The VAS scores,Lysholm scores,and numerical changes in the ratio of the knee joint(medial/lateral)before and after the surgery in the experimental group were compared.ResultsSixteen patients in each of the two groups were included in the standard study.No postoperative complications occurred.The control group was followed up by 14 patients and the experimental group was followed up by 15 patients.The follow-up time was(13.5 ± 2.3)months and(14.7 ± 2.6)months.There was no statistical difference in the general data of the two groups before surgery(P>0.05).The preoperative VAS score,Lysholm score,and knee joint clearance(medial/lateral clearance)were 7.6 ± 1.2 points,54.63 ± 2.37 points,respectively.0.46±0.02;VAS score,Lysholm score and proportion of knee joint clearance(medial/lateral space)were 4.1±1.3 points,80.45±1.94 points,0.49±0.04,respectively;experimental group 6 months after operation VAS score,Lysholm score,and knee joint clearance(medial/lateral clearance)were 3.8±1.1 points,2.71±2.43 points,and 0.55±0.06,respectively;VAS scores,Lysholm scores,and proportions of knee joint clearance in the experimental group at 1 year after surgery(The medial/lateral gaps were 2.6±1.1 points,85.56±0.93 points,and 0.58±0.05,respectively;there was no significant difference at 1 week after surgery(P>0.05),and the difference between the observation indexes at 6 months and 1 year after surgery was observed.All had statistical significance(P<0.05).The VAS score,Lysholm score and the proportion of knee joint clearance(medial/lateral space)in the experimental group at different time points after the operation were significantly different(P<0.05).No postoperative follow-up was found in both groups.There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).ConclusionKnee arthroscopy limited clearance combined with high tibial osteotomy versus limited knee arthroscopic limited clearance in the treatment of medial compartment knee osteoarthritis had better results in VAS scores and Lysholm scores in the medium and long term;imaging also changed The medial and lateral knee gaps and lower limb negative gravity lines relieve symptoms and delay the further progression of osteoarthritis.Combined treatment has many advantages such as low risk,less trauma,low cost,good effect,etc.It is worth popularizing and applying. |
