Short-term Effect Of Arthroscopy Combined With Fibula Osteotomy In The Treatment Of Rupture Of Medial Meniscus Of Knee And Medial Compartment OA

Objective: The purpose of this study was to compare the short-term clinical efficacy of arthroscopic meniscus plasty with arthroscopic meniscus forming combined with proximal fibula osteotomy for the treatment of medial meniscus rupture and medial compartment osteoarthritis.Method: From June 2014 to December 2016,47 patients with medial meniscus rupture associated with medial compartment osteoarthritis of the knee were analyzed retrospectively.According to the method of operation,the patients were divided into menisculoplasty group(n = 25 cases)and combined operation group with arthroscopic meniscus plasty combined with proximal fibula osteotomy(n=22 cases).The average operation time,hospitalization days,hospitalization expenses and complication rate were compared between the two groups,and the preoperative,postoperative the third day,postoperative 1 month,postoperative 3 months,postoperative 6 months,postoperative 12 months the visual analogue score of knees pain(visual analogue scale,VAS score)were compared between the two groups,and the Lysholm score of knees and the IKDC score(the international knee documentation committee knee evaluation form)of the knees were evaluated before operation,6 months after operation,and 12 months after operation between the two groups.The interarticular angle of tibiofemoral joint of knee joint was measured and compared at 6 months and 12 months after operation respectively.The curative effect of patients with different KLS grade was compared according to the X-ray grade.Results:The follow-up time of the two groups was longer than or equal to 12 months.The operation time,hospitalization days and hospitalization expenses in the menisculoplasty group were less than those in the combined operation group(P < 0.05).There was no significant difference in the incidence of complications between the two groups(P > 0.05).Comparison of VAS scores in the two groups,the VAS scores of the two groups decreased on the 3rd day,1 month,3 month,6 month and 12 month after operation(P < 0.05),and the VAS scores decreased at 12 months after operation compared with that at 6 months after operation,and had statistical significance(P < 0.05).Comparison of VAS between groups: there was no significant difference in VAS score between the two groups before operation(P > 0.05).The VAS score of the combined operation group was lower than that of the menisculoplasty group on the 3rd day,1 month,3 month,6 month and 12 month,after operation(P < 0.05)and had statistical significance(P < 0.05).Comparison in two groups: The Lysholm score in both groups increased 6 and 12 months after operation,and the difference was statistically significant(P < 0.05).And so did the IKDC score and statistical significance in the two groups.The scores of Lysholm mite IKDC in the two groups were significantly higher than those in the 6 months after operation(P < 0.05).Comparison between the two groups: there was no significant difference in the Lysholm IKDC score between the two groups before operation(P > 0.05).At 6 months and 12 months after the operation,the Lysholm mite IKDC score in the combined operation group was higher than that in the meniscal arthroplasty group(P < 0.05).There was no difference in the tibiofemoral joint gap angle group(P < 0.05)and there were significant differences(P < 0.05).Comparison of different KLS grades: in the two groups of patients,the VAS score of KLS gradeⅡ,Lysholm score,IKDC score was superior to that of KLS grade Ⅲ respectively.Between the tow groups,the VAS score of KLS gradeⅡand KLS gradeⅢ patient combined operation group,Lysholm score,IKDC score was better than that of meniscus forming group respectively,and had statistical significance(P < 0.05).Conclusion: Arthroscopic meniscus arthroplasty and arthroscopic meniscus arthroplasty combined with proximal fibula osteotomy both can effectively treat the rupture of medial meniscus of knee and medial interventricular osteoarthritis,and the lighter the degree of osteoarthritis,the better the curative effect.Compared with arthroscopic meniscus arthroplasty,combined surgery is more effective and can relieve pain more quickly,but it will increase the operation time,hospitalization day and hospitalization cost.