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-  2018 

膝关节骨关节炎的保膝治疗进展

DOI: doi:10.7507/1002-1892.201807027

Keywords: 膝关节, 骨关节炎, 保膝治疗, 研究进展

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Abstract:

目的 基于遵循阶梯性治疗理念,对膝关节骨关节炎(knee osteoarthritis,KOA)保膝治疗进展作一综述。 方法 查阅近年国内外相关文献,对 KOA 各阶段治疗方法进行总结分析。 结果 KOA 的治疗旨在减轻症状、延缓关节结构性改变、维持关节功能和提高生活质量,因此保守治疗仍是早期 KOA 的首选治疗方法。关节镜手术可协助诊断和分级,并同期行关节内刺激物清理和软骨的有限修复。截骨术适用于下肢负重力线、关节线异常的 KOA,能有效平衡膝关节负重应力,改善症状,缓解疾病进展。关节牵伸术治疗 KOA 能改善膝关节力学环境,一定程度修复缺损软骨,缓解症状。随着技术进步,近年来单髁关节置换(unicompartmental knee arthroplasty,UKA)重新兴起,UKA 属于真正的关节表面置换,是前内侧 KOA 患者保膝治疗的重要手段。 结论 目前 KOA 保膝治疗方法较多,主要针对患者病程以及病情严重程度进行选择。截骨术和 UKA 是临床应用最多且保膝成功率高的重要外科技术,但应注意恰当选择适应证,术者需积累足够临床经验,以取得良好效果

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