[1]高文香,王明君,李晓峰,等.改良髌骨外侧关节面部分切除术治疗严重髌股关节骨关节炎的临床研究[J].中医正骨,2017,29(03):6-9,19.
　GAO Wenxiang,WANG Mingjun,LI Xiaofeng,et al.Clinical study on improved partial lateral patellar facetectomy for treatment of severe patellofemoral joint osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(03):6-9,19.
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改良髌骨外侧关节面部分切除术治疗严重髌股关节骨关节炎的临床研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第29卷
期数:
2017年03期
页码:
6-9,19
栏目:
临床研究
出版日期:
2017-03-20

文章信息/Info

Title:
Clinical study on improved partial lateral patellar facetectomy for treatment of severe patellofemoral joint osteoarthritis
作者:
高文香; 王明君; 李晓峰; 李鹏; 郭明伟; 邹春雨; 郝军
河南省洛阳正骨医院/河南省骨科医院,河南 郑州 450016
Author(s):
GAO Wenxiang; WANG Mingjun; LI Xiaofeng; LI Peng; GUO MingweiZOU Chunyu; HAO Jun
Luoyang Orthopedic-Traumatological Hospital,Zhengzhou 450016,Henan,China
关键词:
骨关节炎; 膝;  髌股关节;  关节成形术
Keywords:
osteoarthritis; knee;  patellofemoral joint;  arthroplasty
摘要:
目的:探讨改良髌骨外侧关节面部分切除术治疗严重髌股关节骨关节炎的临床疗效。方法:选择改良Iwano分期Ⅲ期髌股关节骨关节炎患者60例,按就诊顺序采用随机数字表随机分为观察组和对照组,每组30例。观察组采用改良髌骨外侧关节面部分切除术治疗,对照组采用双醋瑞因胶囊口服联合透明质酸钠注射液膝关节腔内注射治疗。分别于治疗前和末次随访时,采用Merchant法在髌骨轴位X线片上测量髌股适合角判定髌股关节力线情况,并分别采用髌骨改良Kujala评分和美国膝关节协会评分(knee society score,KSS)评价髌股关节和膝关节整体功能。结果:60例患者均获随访,随访时间20～30个月,中位数24个月。治疗前2组患者髌股适合角、髌骨改良Kujala评分、膝关节KSS评分比较,组间差异均无统计学意义[23.07°±10.30°,23.60°±10.05°,t=0.203,P=0.840;(15.93±3.32)分,(14.50±2.87)分,t=1.788,P=0.079;(110.40±15.18)分,(109.13±16.05)分,t=0.314,P=0.755]; 末次随访时,观察组髌股适合角优于对照组,髌骨改良Kujala评分、膝关节KSS评分高于对照组
[11.91°±7.36°,24.13°±9.71°,t=5.495,P=0.000;(32.03±4.20)分,(18.13±7.79)分,t=8.604,P=0.000;(156.77±9.30)分,(115.00±20.25)分,t=10.266,P=0.000]。结论:与双醋瑞因胶囊口服联合透明质酸钠注射液膝关节腔内注射相比,改良髌骨外侧关节面部分切除术治疗严重髌股关节骨关节炎,在恢复髌股关节力线、改善髌股关节和膝关节整体功能方面疗效更佳。
Abstract:
ABSTRACT Objective:To explore the clinical curative effects of improved partial lateral patellar facetectomy for treatment of severe patellofemoral joint osteoarthritis.Methods:Sixty patients with improved Iwano phaseⅢpatellofemoral joint osteoarthritis were randomly divided into observation group and control group according to visit sequence by using random digits table,30 cases in each group.The patients in observation group were treated with improved partial lateral patellar facetectomy,while the patients in control group were treated with oral application of diacerein capsules and intraarticular injection of sodium hyaluronate.The patellofemoral congruence angles(CA)were measured on the patellar transverse x-ray films by using Merchant method for assessing the patellofemoral joint force-lines before treatment and at last follow-up respectively,and the patellofemoral joint function and total knee joint function were evaluated by using modified patellar Kujala score and American knee society score(KSS)respectively.Results:All patients in the 2 groups were followed up for 20-30 months with a median of 24 months.There was no statistical difference in the patellofemoral CA,modified patellar Kujala scores and knee KSS scores between the 2 groups before treatment([23.07+/-10.30 vs 23.60+/-10.05 degrees,t=0.203,P=0.840; 15.93+/-3.32 vs 14.50+/-2.87 points,t=1.788,P=0.079; 110.40+/-15.18 vs 109.13+/-16.05 points,t=0.314,P=0.755].The patellofemoral CA were smaller and the modified patellar Kujala scores and knee KSS scores were higher in observation group compared to control group at the last follow-up(11.91+/-7.36 vs 24.13+/-9.71 degrees,t=5.495,P=0.000; 32.03+/-4.20 vs 18.13+/-7.79 points,t=8.604,P=0.000; 156.77+/-9.30 vs 115.00+/-20.25 points,t=10.266,P=0.000).Conclusion:Better patellofemoral joint force-line and patellofemoral joint function and total knee joint function can be obtained in the treatment of severe patellofemoral joint osteoarthritis by using improved partial lateral patellar facetectomy compared to combination therapy of oral application of diacerein capsules and intraarticular injection of sodium hyaluronate.

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备注/Memo

备注/Memo:
基金项目:河南省中医药科学研究专项课题(2013ZY02030)
更新日期/Last Update: 1900-01-01