족관절의 골관절염에서 관절경적 변연 절제술: 임상적 결과 및 예후 인자

Abstract

Purpose: To evaluate the clinical results of arthroscopic debridement in osteoarthritic ankle and prognostic factors. Materials and Methods: Between Feb. 2001 and Mar. 2004, twenty-seven patients who had an osteoarthritic ankle disease were managed by arthroscopic debridement. The mean age of the patients was 50.0 years (20-71) and the mean follow-up after operation was 16.2 months (12-36). There were 18 men (66.7%) and 9 women (33.3%). The preoperative radiographic findings were divided into 4 groups according to the classification system by Takakura et al. Preoperative AOFAS ankle-hindfoot scale and subjective satisfaction were checked at the last follow-up visit, and the results were compared. Results: In radiological evaluation, stage Ⅰ was 6 cases (22.2%), stage Ⅱ was 14 cases (51.9%), stage Ⅲ was 4 cases (14.8%), and stage Ⅳ was 3 cases (11.1%). The mean preoperative AOFAS ankle-hindfoot scale was 59.1±16.7 and improved to 66.5±24.3 at last follow-up. Especially, in stage Ⅰ, preoperative AOFAS score was 69.3±18.7 and improved to 74.3±29.7, and in stage Ⅱ, preoperative AOFAS socre was 63.0±9.6 and improved to 77.1±12.9. But in the stage Ⅲ and Ⅳ, preoperative scores were not improved. The preoperative radiographic findings correlated with the outcome at the last follow-up time (p<0.05). The group with loose body and the group without anterior osteophyte showed better AOFAS score compared to the control group, but there was no statistically significant difference between the two-groups. In subjective satisfaction, excellent or good results were achieved in 14 cases (51%). Conclusion: We suggest that arthroscopic debridement is an effective treatment in which preservation of alignment and reasonable articular cartilage can be achieved.