EFFECT OF HIGH TIBIAL OSTEOTOMY ON OSTEOARTHRITIS OF THE KNEE - CLINICAL AND HISTOLOGICAL OBSERVATIONS
EFFECT OF HIGH TIBIAL OSTEOTOMY ON OSTEOARTHRITIS OF THE KNEE - CLINICAL AND HISTOLOGICAL OBSERVATIONS
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DOI：
10.1007/bf00266324
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发表时间：
1979-01-01
影响因子：
2.7
通讯作者：
TSUCHIYA, K
中科院分区：
文献类型：
--
作者：
KOSHINO, T;TSUCHIYA, K
对 136 个患有骨关节炎的膝盖进行了胫骨高位截骨术，以矫正内翻畸形。截骨前，所有患者均出现中度或重度疼痛，膝盖在负重时出现侧向推力。对患者进行一到五年的随访。 112个膝关节疼痛得到明显缓解，122个膝关节患者对手术结果感到满意。这些无痛膝关节没有出现侧向推力，大多数畸形已得到充分矫正，术后股骨胫骨角度（站立）范围为165°至174°。术后一年测量时，股骨-胫骨角度为 175° 至 179° 的 28 个膝关节中，有 4 个膝关节在截骨术后三年内出现内翻畸形复发。即使同时进行了关节切开术，截骨术后膝关节的术前活动范围也得到了很好的维持。术后几年对两名患者进行的关节内评估显示，关节面退化最严重的部分完全被纤维软骨层覆盖，没有裸骨。当股骨-胫骨角度（站立）矫正为170°（外翻10°）时，胫骨高位截骨术对于伴有内翻畸形的骨关节炎膝关节最为有效。
High tibial osteotomies were performed on 136 osteoarthritic knees for correction of varus deformity. Before osteotomy all patients experienced moderate or severe pain, and the knees showed lateral thrust on weight-bearing. The patients were followed up for one to five years. Marked relief of pain was obtained in 112 knees, and the patients were satisfied with the result of operation in 122. These painless knees showed no lateral thrust, and in the majority the deformity had been adequately corrected, with post-operative femoro-tibial angles (standing) ranging from 165° to 174°. Four of 28 knees with femoro-tibial angles of 175° to 179°, when measured one year after operation, showed recurrence of varus deformity three years after osteotomy. Preoperative ranges of knee motion were well maintained after osteotomy even when arthrotomy had also been undertaken. Intra-articular assessment in two patients, several years after operation, showed that the most degenerated portions of the articular surface were completely covered by a fibrocartilagenous layer, with no bare bone.High tibial osteotomy is most effective in osteoarthritic knees with varus deformity, when correction is made to a femoro-tibial angle (standing) of 170° (10° valgus).