Long-Term Survivorship of Closed-Wedge High Tibial Osteotomy for Severe Knee Osteoarthritis: Outcomes After 10 to 37 Years.
Long-Term Survivorship of Closed-Wedge High Tibial Osteotomy for Severe Knee Osteoarthritis: Outcomes After 10 to 37 Years.
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DOI：
10.1177/23259671211046964
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发表时间：
2021-10
影响因子：
2.6
通讯作者：
Imagama S
中科院分区：
文献类型：
--
作者：
Ishizuka S;Hiraiwa H;Yamashita S;Oba H;Kawamura Y;Sakaguchi T;Idota M;Hasegawa Y;Imagama S
胫骨高位截骨术（HTO）是一种保留关节的手术，用于治疗相对年轻的孤立性膝关节内侧间室骨关节炎（OA）患者。HTO后的长期生存率对于确定患者是否需要额外手术非常重要。确定闭合楔形HTO（CWHTO）治疗严重内侧OA的长期（>35年）生存率和预后因素。病例系列;证据等级，4级。我们回顾性评价了1983年至2009年在我们的机构，名古屋大学医学研究生院（名古屋，日本）接受CWHTO治疗严重内侧膝关节OA的患者。对患者人口统计学资料、随访期以及术前和术后股骨-胫骨角度（FTA）进行了审查。通过电话采访患者或患者亲属，记录术后状态，包括转为全膝关节置换术（TKA）。在进行的74例CWHTO手术中，我们评价了45例患者的56例手术（手术时平均年龄为56.8岁）。平均随访时间为17.1年。9例膝关节（16.1%）转为TKA。TKA转换的平均时间为15.6年。Kaplan-Meier分析显示10年生存率为90.1%，15年生存率为83.8%，20年生存率为75.9%，35年生存率为75.9%。对数秩检验显示，年龄≥55岁（P = .044）、体重指数（BMI）≥25 kg/m2（P = .0016）和术前FTA <185°（P = .0034）是与TKA转换相关的风险因素。经年龄和性别校正的多变量分析确定BMI ≥25 kg/m2（风险比[HR]，13.4; 95% CI，1.7-106.9; P = 0.014）和术前FTA <185°（HR，4.2; 95% CI，1.1-16.6; P = 0.04）是与TKA转换相关的风险因素。严重内侧膝关节OA的CWHTO术后10年生存率为90.1%，15年生存率为83.8%，20年和35年生存率为75.9%。此外，BMI ≥25 kg/m2和FTA <185°是与CWHTO后TKA转换相关的独立风险因素。
High tibial osteotomy (HTO) was developed as a joint-preserving procedure to treat relatively young patients with isolated medial compartmental knee osteoarthritis (OA). Long-term survivorship after HTO is important to determine whether patients will need additional surgery. To determine the long-term (>35-year) survivorship and prognostic factors for closed-wedge HTO (CWHTO) for severe medial OA. Case series; Level of evidence, 4. We retrospectively evaluated patients who underwent CWHTO for severe medial knee OA between 1983 and 2009 at our institution, Nagoya University Graduate School of Medicine (Nagoya, Japan). Patient demographics, follow-up period, and pre- and postoperative femoral-tibial angle (FTA) were reviewed. The patients or the relatives of the patients were interviewed by telephone to record postoperative status, including conversion to total knee arthroplasty (TKA). Of the 74 CWHTO procedures performed, we evaluated 56 procedures in 45 patients (mean age at time of surgery, 56.8 years). The mean follow-up period was 17.1 years. Nine knees (16.1%) underwent conversion to TKA. The mean time to TKA conversion was 15.6 years. Kaplan-Meier analysis revealed a 10-year survival rate of 90.1%, a 15-year rate of 83.8%, a 20-year rate of 75.9%, and a 35-year rate of 75.9%. Log-rank test showed that age ≥55 years (P = .044), body mass index (BMI) ≥25 kg/m2 (P = .0016), and preoperative FTA <185° (P = .0034) were risk factors associated with TKA conversion. Multivariate analyses adjusted for age and sex identified BMI ≥25 kg/m2 (hazard ratio [HR], 13.4; 95% CI, 1.7-106.9; P = .014) and preoperative FTA <185° (HR, 4.2; 95% CI, 1.1-16.6; P = .04) as risk factors associated with TKA conversion. The survival rate of CWHTO for severe medial knee OA was 90.1% at 10 years, 83.8% at 15 years, and 75.9% at 20 years and 35 years. Furthermore, a BMI ≥25 kg/m2 and FTA <185° were the independent risk factors associated with TKA conversion after CWHTO.
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影响因子：
1.7
作者：
Kuwashima, Umito;Okazaki, Ken;Nakashima, Yasuharu
通讯作者：
Nakashima, Yasuharu
DOI：
10.3969/j.issn.1003-0034.2018.12.017
发表时间：
2018-12-25
影响因子：
--
作者：
Fu, You-Wei;Liu, Bing-Gen;Pang, Qing-Jiang
通讯作者：
Pang, Qing-Jiang
影响因子：
2.6
作者：
Santoso MB;Wu L
通讯作者：
Wu L
影响因子：
4.8
作者：
Hui, Catherine;Salmon, Lucy J.;Pinczewski, Leo A.
通讯作者：
Pinczewski, Leo A.
影响因子：
3.8
作者：
Berruto, M.;Maione, A.;Usellini, E.
通讯作者：
Usellini, E.