摘要： 目的 探讨胫骨高位截骨联合Taylor外固定架治疗膝骨性关节炎并膝内翻的临床疗效。方法 纳入20例膝骨性关节炎并膝内翻患者，采用胫骨高位截骨矫形联合Taylor外固定架固定治疗，术后拍摄双下肢全长X线片和膝关节正侧位X线片，测量畸形参数和安装参数，根据Taylor外固定架配套软件计算电子处方调整外固定支架，精确恢复骨折对位和下肢力线。术后定期随访，观察下肢力线和膝内翻恢复情况；评估患者疼痛、膝关节功能的变化。结果 20例患者均顺利完成手术，手术时间55~80 min，平均（65.52±9.53）min。术后14 d拆线，未出现神经损伤、血栓、髌骨轨迹异常等严重并发症；下肢力线满意，膝内翻已纠正。患者术前视觉模拟评分（VAS评分）、胫股骨角（FTA）、美国特种外科医院膝关节评分（HSS评分）、美国膝关节协会评分（KSS评分）分别为（6.89±1.45）分、（184.5±2.2）°、（70.26±4.52）分、（72.16±4.26）分，术后12个月分别为（1.36±0.24）分、（170.69±0.57）°、（88.45±5.29）分、（85.42±5.72）分，术后VAS评分、FTA低于治疗前（P < 0.05），HSS评分、KSS评分高于治疗前（P < 0.05）。结论 胫骨高位截骨联合Taylor外固定架治疗膝骨性关节炎并膝内翻的临床疗效突出，可纠正患者膝内翻，降低患者疼痛程度，改善膝关节功能。

胫骨高位截骨联合Taylor外固定架治疗膝骨性关节炎并膝内翻的临床疗效

姚恩洋¹, 田野²

1. 中国医科大学附属盛京医院手足踝显微外科, 沈阳 110004;
2. 中国医科大学附属盛京医院脊柱关节外科, 沈阳 110004

收稿日期:2020-02-28出版日期:2020-07-30发布日期:2020-07-02
通讯作者:田野E-mail:tiany3@sj-hospital.org
作者简介:姚恩洋(1987-),男,医师,硕士.
基金资助:国家自然科学基金（81970760）


关键词: 膝骨性关节炎, 膝内翻, 胫骨高位截骨矫形术, Taylor外固定架
Abstract: Objective To investigate the clinical efficacy of high tibial osteotomy and Taylor external fixation for knee osteoarthritis and knee varus. Methods A total of 20 patients with knee osteoarthritis and varus knee were treated with high tibial osteotomy and Taylor external fixation. Regular follow-up was performed to observe the recovery of lower limb force line and knee varus,and to evaluate the changes in pain and knee function of the patients. Results All 20 patients successfully completed the operation. The operation time was 55 to 80 minutes (mean±SD,65.52±9.53 minutes). The suture was removed 14 days after operation. No serious complications such as nerve injury,thrombosis,and abnormal sacral trajectory occurred. The lower limb force line was satisfactory,and the knee varus was corrected. The preoperative visual analogue (VAS) score,femoral-tibial angle (FTA),hospital for special surgery (HSS) score,and Knee Society Knee scoring system (KSS) score were 6.89±1.45,184.5°±2.2°,70.26±4.52,and 72.16±4.26,and were 1.36±0.24, 170.69°±0.57°,88.45±5.29,and 85.42±5.72 at 12 months after surgery. The VAS score and FTA of the patients after operation were lower than those before operation,and the HSS and KSS scores after operation were higher than those before operation (P < 0.05). Conclusion High tibial osteotomy combined with Taylor external fixation for the treatment of knee osteoarthritis and knee varus is effective. It can correct varus,reduce pain,and improve knee function.
Key words: knee osteoarthritis, varus knee, high tibial osteotomy, Taylor external fixator
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