Osteotomy Around the Knee: The Surgical Treatment of Osteoarthritis.
Osteotomy Around the Knee: The Surgical Treatment of Osteoarthritis.
复制标题
膝关节周围截骨术：骨关节炎的手术治疗。
DOI：
10.1111/os.13021
复制
发表时间：
2021-07
影响因子：
2.1
通讯作者：
Zhang Y
中科院分区：
文献类型：
--
作者：
Peng H;Ou A;Huang X;Wang C;Wang L;Yu T;Zhang Y;Zhang Y
骨关节炎会引起关节疼痛和功能障碍，其中以膝骨关节炎最为常见。目前临床上有效的治疗方法主要有保守治疗、关节置换术、截骨术等。然而，保守治疗只能缓解症状，关节置换术仅限于中度至重度骨关节炎患者。对于年龄相对较小、需要更大程度保留膝关节的患者，需要手术创伤小、翻修率低的手术治疗。基于“保留膝盖”的概念，膝盖周围截骨术已被选为替代手术治疗方法。切割和重新排列骨骼可以纠正下肢受力的机械线。因此，膝关节周围截骨术保留了正常的解剖结构，并获得了膝关节良好的功能恢复。膝关节周围截骨技术包括抗内翻畸形截骨术和抗外翻畸形截骨术，旨在重新分配膝关节间室的受力。通过选择下肢手术断面，膝关节周围截骨可以实现机械轴的矫正，如胫骨高位截骨术（HTO）、腓骨近端截骨术（PFO）、股骨远端截骨术（DFO）等。在传统方法的基础上，已经开发出许多改良技术来满足患者的需求。这些改良截骨术都有各自的优点和适应症。本文旨在通过回顾在临床实践中广泛研究和应用的不同类型的截骨术及其效果来指导临床治疗。膝关节周围截骨术（OAK）是膝骨关节炎（OA）的临床治疗方法之一，基于“保留膝关节”的理念，主要适用于相对年轻和高需求的患者。 OAK的原理是矫正下肢的机械轴。根据畸形类型，可分为防内翻畸形和防外翻畸形截骨术。根据下肢手术断面的选择，防内翻畸形和防外翻畸形截骨术又可分为胫骨高位截骨术（HTO）、腓骨近端截骨术（PFO）和股骨远端截骨术（DFO）。截骨术操作简便、风险低、几乎所有病例术后恢复快，已被选为替代手术治疗方法。
Osteoarthritis causes joint pain and functional disorder, of which knee osteoarthritis is the most common. Nowadays, clinically effective treatments mainly include conservative treatment, arthroplasty, and osteotomy. However, conservative treatment only offers symptomatic relief and arthroplasty is limited to the patients with a moderate to severe degree of osteoarthritis. For relatively young patients who require greater knee preservation, a surgical treatment with low operation trauma and revision rate is needed. Osteotomy around the knee, based on the notion of “knee preservation,” has been chosen as an alternative surgical treatment. Cutting and realigning the bones corrects the mechanical line of lower limb force bearing. As such, osteotomy around the knee retains normal anatomical structure and obtains good functional recovery of the knee joint. The techniques of osteotomy around the knee includes anti‐varus deformity and anti‐valgus deformity osteotomy, aiming to reallocate the force bearing in the compartment of the knee joint. By choosing the surgical section of the lower limbs, the osteotomy around the knee can achieve the correction of mechanical axis, such as the high tibial osteotomy (HTO), proximal fibular osteotomy (PFO), and distal femur osteotomy (DFO). Numerous modified techniques have been developed to meet the demands of patients based on traditional methods. These modified osteotomy have their own advantages and indications. This paper aims to guide clinical treatment by reviewing different types of osteotomies, and their effects, that have been studied and applied widely in clinical practices. Osteotomy around the knee (OAK), one of the clinical treatments for knee osteoarthritis (OA), is based on the notion of “knee preservation” and primarily applies to relatively young and high‐demand patients. The principle of OAK is to correct the mechanical axis in the lower limbs. According to the types of deformity, the techniques can be divided into anti‐varus deformity and anti‐valgus deformity osteotomy. By choosing the surgical section of the lower limbs, anti‐varus deformity and anti‐valgus deformity osteotomy can be further divided into high tibial osteotomy (HTO), proximal fibular osteotomy (PFO), and distal femur osteotomy (DFO). Osteotomy is easy to conduct, low‐risk, almost all cases have rapid recovery after surgery, and it has been chosen as an alternative surgical treatment.
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DOI：
10.2106/00004623-198769010-00006
发表时间：
1987-01-01
影响因子：
5.3
作者：
COVENTRY, MB
通讯作者：
COVENTRY, MB
影响因子：
3.8
作者：
Collins, Brett;Getgood, Alan;Litchfield, Robert B.
通讯作者：
Litchfield, Robert B.
影响因子：
3.8
作者：
Dewilde, T. R.;Dauw, J.;Bellemans, J.
通讯作者：
Bellemans, J.
影响因子：
2.3
作者：
Chiba K;Yonekura A;Miyamoto T;Osaki M;Chiba G
通讯作者：
Chiba G
影响因子：
2.3
作者：
Agneskirchner, JD;Hurschler, C;Lobenhoffer, P
通讯作者：
Lobenhoffer, P