關節鏡輔助下與開放性踝關節融合術的療效比較_《中國修復重建外科雜志》

作者：

孟慶陽 , 于騰波 , 虞連奎 , 趙夏 , 戚超

青島大學醫學院附屬醫院關節外科（山東青島，266003）;

關鍵詞：

踝關節融合術關節鏡手術開放手術

DOI：

10.7507/1002-1892.20130066

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目的比較關節鏡輔助下與開放性踝關節融合術的療效。方法回顧分析2008年1月－2011年1 月收治的30例行單側踝關節融合術患者臨床資料，其中關節鏡輔助下手術14例（關節鏡組），開放手術16例（開放式組）。兩組患者性別、年齡、病損類型、病程及術前美國矯形足踝協會（AOFAS）評分比較，差異均無統計學意義（P gt; 0.05）。通過手術時間、術中出血量、術后住院時間、術后AOFAS評分及骨性融合率對兩組臨床療效進行評估。結果關節鏡組手術時間顯著長于開放式組，術中出血量及術后住院時間均顯著少于開放式組，差異均有統計學意義（P lt; 0.05）。開放式組術后發生1例切口淺表感染，余患者切口均Ⅰ期愈合。兩組患者均獲隨訪12個月。X線片復查示，兩組均無螺釘斷裂發生。術后3個月關節鏡組和開放式組分別有13例（92.86%）和10例（62.50%）植骨達骨性融合，比較差異有統計學意義（χ2=3.850，P=0.049）；12個月時關節鏡組14例（100%）均達骨性融合，開放式組15例（93.75%）達骨性愈合，比較差異無統計學意義（χ2=0.910，P=0.341）。兩組術后各時間點AOFAS評分均較術前顯著提高（P lt; 0.05）；術后1、3個月兩組AOFAS評分比較差異無統計學意義（P gt; 0.05），但6、12個月時差異有統計學意義（P lt; 0.05）。結論關節鏡輔助下行踝關節融合術具有術中出血少、住院時間短、早期融合率高、術后關節功能恢復好的優點，整體臨床療效優于開放性踝關節融合術。

引用本文： 孟慶陽,于騰波,虞連奎,趙夏,戚超. 關節鏡輔助下與開放性踝關節融合術的療效比較. 中國修復重建外科雜志, 2013, 27(3): 288-291. doi: 10.7507/1002-1892.20130066 復制

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6.	Hendrickx RP, Stufkens SA, de Bruijn EE, et al. Medium- to long-term outcome of ankle arthrodesis. Foot Ankle Int, 2011, 32(10): 940-947.
7.	SooHoo NF, Zingmond DS, Ko CY. Comparison of reoperation rates following ankle arthrodesis and total ankle arthroplasty. J Bone Joint Surg (Am), 2007, 89(10): 2143-2149.
8.	Haddad SL, Coetzee JC, Estok R, et al. Intermediate and long-term outcomes of total ankle arthroplasty and ankle arthrodesis. A systematic review of the literature. J Bone Joint Surg (Am), 2007, 89(9): 1899-1905.
9.	Lee MS. Arthroscopic Ankle Arthrodesis. Clin Podiatr Med Surg, 2011, 28(3): 511-521.
10.	Gougoulias NE, Agathangelidis FG, Parsons SW. Arthroscopic ankle arthrodesis. Foot Ankle Int, 2007, 28(6): 695-706.
11.	Cottino U, Collo G, Morino L, et al. Arthroscopic ankle arthrodesis: a review. Curr Rev Musculoskelet Med, 2012, 5(2): 151-155.
12.	唐恒濤, 蘇訓同, 王義雋, 等. 關節鏡輔助下踝關節融合術. 中國修復重建外科雜志, 2010, 24(9): 1147-1148.
13.	Peterson KS, Lee MS, Buddecke DE. Arthroscopic versus open ankle arthrodesis: a retrospective cost analysis. J Foot Ankle Surg, 2010, 49(3): 242-247.
14.	Dannawi Z, Nawabi DH, Patel A, et al. Arthroscopic ankle arthrodesis: are results reproducible irrespective of pre-operative deformity？Foot Ankle Surg, 2011, 17(4): 294-299.
15.	Nielsen KK, Linde F, Jensen NC. The outcome of arthroscopic and open surgery ankle arthrodesis: A comparative retrospective study on 107 patients. Foot and Ankle Surgery, 2008, 14(3): 153-157.
16.	Winson IG, Robinson DE, Allen PE. Arthroscopic ankle arthrodesis. J Bone Joint Surg (Br), 2005, 87(3): 343-347.
17.	Ferkel RD, Hewitt M. Long-term results of arthroscopic ankle arthrodesis. Foot Ankle Int, 2005, 26(4): 275-280.

1. Piriou P, Culpan P, Mullins M, et al. Ankle replacement versus arthrodesis: a comparative gait analysis study. Foot Ankle Int, 2008, 29(1): 3-9.
2. 廖翔, 高志增, 黃山虎, 等. 人工全踝關節置換術圍手術期并發癥. 中國修復重建外科雜志, 2008, 22(1): 40-43.
3. Barg A, Knupp M, Anderson AE, et al. Total ankle replacement in obese patients: component stability, weight change, and functional outcome in 118 consecutive patients. Foot Ankle Int, 2011, 32(10): 925-932.
4. Henricson A, Nilsson JÅ, Carlsson A. 10-year survival of total ankle arthroplasties: a report on 780 cases from the Swedish Ankle Register. Acta Orthop, 2011, 82(6): 655-659.
5. Nihal A, Gellman RE, Embil JM, et al. Ankle arthrodesis. Foot Ankle Surg, 2008, 14(1): 1-10.
6. Hendrickx RP, Stufkens SA, de Bruijn EE, et al. Medium- to long-term outcome of ankle arthrodesis. Foot Ankle Int, 2011, 32(10): 940-947.
7. SooHoo NF, Zingmond DS, Ko CY. Comparison of reoperation rates following ankle arthrodesis and total ankle arthroplasty. J Bone Joint Surg (Am), 2007, 89(10): 2143-2149.
8. Haddad SL, Coetzee JC, Estok R, et al. Intermediate and long-term outcomes of total ankle arthroplasty and ankle arthrodesis. A systematic review of the literature. J Bone Joint Surg (Am), 2007, 89(9): 1899-1905.
9. Lee MS. Arthroscopic Ankle Arthrodesis. Clin Podiatr Med Surg, 2011, 28(3): 511-521.
10. Gougoulias NE, Agathangelidis FG, Parsons SW. Arthroscopic ankle arthrodesis. Foot Ankle Int, 2007, 28(6): 695-706.
11. Cottino U, Collo G, Morino L, et al. Arthroscopic ankle arthrodesis: a review. Curr Rev Musculoskelet Med, 2012, 5(2): 151-155.
12. 唐恒濤, 蘇訓同, 王義雋, 等. 關節鏡輔助下踝關節融合術. 中國修復重建外科雜志, 2010, 24(9): 1147-1148.
13. Peterson KS, Lee MS, Buddecke DE. Arthroscopic versus open ankle arthrodesis: a retrospective cost analysis. J Foot Ankle Surg, 2010, 49(3): 242-247.
14. Dannawi Z, Nawabi DH, Patel A, et al. Arthroscopic ankle arthrodesis: are results reproducible irrespective of pre-operative deformity？Foot Ankle Surg, 2011, 17(4): 294-299.
15. Nielsen KK, Linde F, Jensen NC. The outcome of arthroscopic and open surgery ankle arthrodesis: A comparative retrospective study on 107 patients. Foot and Ankle Surgery, 2008, 14(3): 153-157.
16. Winson IG, Robinson DE, Allen PE. Arthroscopic ankle arthrodesis. J Bone Joint Surg (Br), 2005, 87(3): 343-347.
17. Ferkel RD, Hewitt M. Long-term results of arthroscopic ankle arthrodesis. Foot Ankle Int, 2005, 26(4): 275-280.

《中國修復重建外科雜志》

關節鏡輔助下與開放性踝關節融合術的療效比較

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《中國修復重建外科雜志》

關節鏡輔助下與開放性踝關節融合術的療效比較

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