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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Combination of Proximal Fibulectomy with Arthroscopic Partial Meniscectomy for Medial Compartment Osteoarthritis Accompanied by Medial Meniscal Tear
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Combination of Proximal Fibulectomy with Arthroscopic Partial Meniscectomy for Medial Compartment Osteoarthritis Accompanied by Medial Meniscal Tear

机译：近端腓骨切除联合关节镜部分半月板切除术治疗伴有半月板内侧撕裂的内室骨关节炎

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Medial compartment osteoarthritis is usually accompanied by medial meniscal tear. The treatment of symptomatic mild medial compartment osteoarthritis and medial meniscal tears in middle-aged and elderly patients is controversial.Aim: This study aimed to assess the efficacy of proximal fibulectomy combined with Arthroscopic Partial Meniscectomy (APM) for symptomatic middle-aged and elderly patients with mild medial compartment osteoarthritis and medial meniscal tears.Materials and Methods: Consecutive hospitalised patients treated with concomitant proximal fibulectomy and APM from April 2013 to June 2014 were included in the study. Proximal fibulectomy and APM were done by the same group of surgeons. APM was performed initially to manage medial meniscal tears. This was followed by the proximal fibulectomy, during which a 20-mm long proximal fibular segment was excised. Preoperative and postoperative Visual Analog Scale (VAS) pain scores, Hospital for Special Surgery (HSS) knee scores, and Ahlb?ck grading of knee osteoarthritis were collected. Postoperative complications and subjective patient satisfaction were recorded. For statistical analysis of the VAS and HSS score, Wilcoxon signed-rank test and the paired t-test were used to compare over time, respectively.Results: A total of 31 out of 38 patients were included. Seven patients were excluded due to follow up loss. The mean follow up duration was 25.3±1.5 months. The postoperative median VAS score and Interquartile Range (IQR) were 0 (0?1), which was significantly lower than the preoperative median VAS score and interquartile range 6 (5?7) (p< 0.001). The mean HSS score improved from 78.2±8.2 points preoperatively to 90.1±4.5 points postoperatively (p< 0.001). No patients had radiographic evidence of osteoarthritis progression or fibular bony union, or required conversion to other surgeries. Subjective patient satisfaction was rated very satisfied in 7 patients (22.6%), satisfied in 20 patients (64.5%), fairly satisfied in 3 patients (9.7%), and not satisfied in 1 patient (3.2%). Complication in a single patient included a temporary palsy of the superficial peroneal nerve.Conclusion: Proximal fibulectomy combined with APM produced satisfactory surgical outcomes in our patient cohort at two years after treatment. Concomitant proximal fibulectomy and APM may be considered to be a safe and minimally invasive treatment.
机译：内侧腔室骨关节炎通常伴有内侧半月板撕裂。目的：本研究旨在评估近端腓骨切除术联合关节镜部分半月板切除术（APM）对有症状的中年人的疗效。 材料与方法：研究对象为2013年4月至2014年6月连续接受近端腓骨切除术和APM治疗的住院患者。腓骨近端切除术和APM由同一组外科医生完成。最初进行APM是为了控制内侧半月板撕裂。随后进行近端腓骨切除术，在此期间，切除了一个20 mm长的近端腓骨节段。收集术前和术后的视觉模拟量表（VAS）疼痛评分，特殊外科医院（HSS）膝关节评分以及膝骨关节炎的Ahlb？ck评分。记录术后并发症和主观患者满意度。为了对VAS和HSS评分进行统计分析，分别使用了Wilcoxon秩和检验和配对t检验进行比较。结果：38例患者中共有31例。由于随访损失，排除了七名患者。平均随访时间为25.3±1.5个月。术后VAS中位数和四分位间距（IQR）为0（0？1），显着低于术前VAS中位数和四分位间距6（5？7）（p <0.001）。平均HSS评分从术前的78.2±8.2分提高到术后的90.1±4.5分（p <0.001）。没有患者的影像学证据表明骨关节炎进展或腓骨骨结合，或需要转换为其他手术。主观患者的满意度为7例（22.6％），2例（64.5％），3例（9.7％），1例（3.2％）。单例患者的并发症包括腓浅神经的暂时性麻痹。结论：在治疗后两年，近端腓骨切除术联合APM在我们的患者队列中产生了令人满意的手术结果。伴有近端腓骨切除术和APM可能被认为是一种安全且微创的治疗方法。

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