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激光标线仪在内侧开放楔形胫骨近端高位截骨术中的应用

Application of laser reticle equipment in medial open-wedge high tibial osteotomy

    摘要
  • 摘要:
    目的 观察激光标线仪在提高内侧开放楔形胫骨近端高位截骨术（MOWHTO）中的应用效果。
    方法 将60例膝关节骨性关节炎患者纳入本研究，其中30例术中按照传统定位法测量下肢力线（对照组），另外30例术中使用激光标线仪实时显示下肢力线（观察组）。比较2组手术时间、术中C臂使用次数、引流量、OA距离，并比较术前、术后3个月和6个月的视觉模拟评分法（VAS）评分、美国特种外科医院（HSS）膝关节功能评分及屈膝最大角度。比较2组并发症和不良反应。
    结果 与对照组比较，观察组手术时间、引流量、C臂使用次数及OA距离均较短或较少，差异有统计学意义（P < 0.05）。与对照组比较，观察组术后3个月的VAS评分较低，膝关节HSS评分较高，差异有统计学意义（P < 0.05）。2组患者术后6个月的屈膝最大角度与术后3个月比较，差异有统计学意义（P < 0.05）；与对照组比较，观察组术后3个月的屈膝最大角度较大，差异有统计学意义（P < 0.05）。对照组发生1例下肢深静脉血栓，给予对症处理后未出现严重不良反应。观察组患者未发生并发症或不良反应。
    结论 MOWHTO术中使用激光标线仪标记下肢力线可有效缩短手术时间和OA距离，减少引流量、C臂使用次数，改善术后VAS评分、膝关节HSS评分及屈膝最大角度。

     

    Abstract:
    Objective To observe the application effect of laser reticle equipment in medial open-wedge high tibial osteotomy(MOWHTO).
    Methods A total of 60 patients with knee osteoarthritis were included in the study, among whom 30 patients underwent traditional positioning method to measure the lower extremity alignment (control group) and 30 cases used a laser reticle equipment to display the lower extremity alignment in real time (observation group). The operation time, intraoperative C-arm usage times, drainage volume and OA distance were compared between two groups. The visual analogue scale (VAS), the knee function score of Hospital for Special Surgery(HSS) and the maximum angle of knee flexion were compared between two groups before operation and 3 and 6 months after the operation. The complications and adverse reactions of two groups were compared.
    Results Compared with the control group, the operation time, volume of drainage, C-arm usage times and OA distance in the observation group were significantly reduced or shortened (P < 0.05). Compared with the control group, the VAS score of the observation group was lower and the knee HSS score was higher 3 months after surgery, the differences were statistically significant (P < 0.05). The maximum angle of knee bending 6 months after surgery showed significant difference compared with that 3 months after surgery (P < 0.05). Compared with the control group, the observation group had a larger maximum bending angle 3 months after surgery, and the difference was statistically significant (P < 0.05). The control group had one case of deep venous thrombosis of lower extremity, and no serious adverse reactions occurred after symptomatic treatment. No complications or adverse reactions occurred in the observation group.
    Conclusion The laser reticle equipment used to mark the lower limb alignment in MOWHTO operation can shorten the operation time and OA distance, reduce drainage volume and C-arm usage times, and improve postoperative VAS score, knee HSS score and maximum knee flexion angle.

     

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