Clinical results of a valgus high tibial osteotomy for the treatment of osteoarthritis of the knee and the ipsilateral ankle
Clinical results of a valgus high tibial osteotomy for the treatment of osteoarthritis of the knee and the ipsilateral ankle
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DOI：
10.1016/j.knee.2008.02.002
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发表时间：
2008-06-01
期刊：
影响因子：
1.9
通讯作者：
Koshino, Tomihisa
中科院分区：
文献类型：
--
作者：
Takeuchi, Ryohei;Saito, Tomoyuki;Koshino, Tomihisa
膝关节骨关节炎伴同侧踝关节骨关节炎患者的治疗尚无良好记录。我们在这里报告的临床结果和影像学评价，这样的病人采用胫骨高位截骨术（HTO）。对10例患者（均为女性，平均年龄68岁，范围58 - 73岁）的16个膝关节进行了HTO，这些患者因膝关节内侧间室骨关节炎而导致双腿内翻畸形。采用特殊外科医院膝关节评分系统（HSS评分）和Kitaoka踝后足临床评分系统（AOFAS）对HTO前后患者进行临床评价。使用术前拍摄的整个下肢的前后单腿负重X线片测量影像学结果。平均随访8年（4- 10年），HSS评分由HTO前的54分提高到HTO后的91分，踝关节评分由HTO前的54分提高到HTO后的86分。HTO后，膝关节对线也从6度内翻变为12度外翻。胫骨轴线倾斜角由外侧10 °下降到内侧-2 °，距骨倾斜角由18 °改善到6 °，踝关节一致性得到改善，HTO能纠正下肢的整体对线，是治疗同侧膝关节和踝关节骨关节炎的有效手术方法之一。(C)2008 Elsevier B. V.保留所有权利。
The treatment of patients with osteoarthritic knees accompanied by ipsilateral osteoarthritic ankles is not well documented. We here report both clinical results and radiographic evaluations of such patients treated using a high tibial osteotomy (HTO). HTO was performed on 16 knees of 10 patients (all women with a mean age; 68years; range 58 to 73years) who bad a varus deformity of both their legs as a result of medial compartmental osteoarthritis of their knees. The Hospital for Special Surgery's (HSS score) knee scoring system and the clinical rating system for the ankle-hindfoot by Kitaoka (AOFAS) were used to evaluate the patients clinically before and after HTO. Radiographic findings were measured using antero-posterior one-leg weight bearing radiographs of the whole lower extremity taken before surgery. The mean time of follow-up was 8years (range, 4-10years).The HSS score improved from 54 to 91 points after HTO and the mean ankle score improved significantly from 54 to 86 points. After HTO also, the alignment of the knees changed from 6 degrees varus to 12 degrees valgus. The decrease of the inclination angle of the tibial axis changed from 10 degrees laterally to -2 degrees medially and the talar tilt angle improved from 18 degrees to 6 degrees resulting in an improvement of the ankle congruity.HTO, which can correct the total alignment of the lower extremity, is thus recommended as one of more effective surgical procedures for patients with an ipsilateral osteoarthritis of the knee and ankle. (C) 2008 Elsevier B.V. All rights reserved.