PROXIMAL TIBIAL VARUS OSTEOTOMY FOR OSTEOARTHRITIS OF THE LATERAL COMPARTMENT OF THE KNEE
PROXIMAL TIBIAL VARUS OSTEOTOMY FOR OSTEOARTHRITIS OF THE LATERAL COMPARTMENT OF THE KNEE
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DOI：
10.2106/00004623-198769010-00006
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发表时间：
1987-01-01
影响因子：
5.3
通讯作者：
COVENTRY, MB
中科院分区：
文献类型：
--
作者：
COVENTRY, MB
从1960年到1979年，我们对31例膝关节（28例患者）进行了胫骨近端闭合楔形内翻截骨术，治疗伴有外翻畸形的膝关节外侧骨关节炎疼痛。随访2 ~ 17年（平均9.4年）。24个膝关节（77%）在最后一次评估时没有疼痛或只有偶尔的轻微疼痛。六个膝盖有中度疼痛，一个膝盖有剧烈疼痛。6个膝关节在截骨术后平均9.8年需要进行全膝关节置换术。没有患者有感染或不愈合。胫骨近端截骨术是治疗外翻畸形膝单室退行性关节炎的一种合理方法。虽然一些解剖性外翻畸形高达20度的患者在本系列中获得了良好的结果，但如果外翻角度超过12度或手术导致的胫骨关节面倾斜超过10度，则股骨髁上区域截骨可能更可取。建议将外翻角超过正常的5 ~ 7度矫正为零度的解剖性胫股对准，以防止外翻畸形复发，并减少胫股外侧腔室的负荷。
From 1960 through 1979, a closing-wedge varus osteotomy of the proximal part of the tibia was performed in thirty-one knees (twenty-eight patients) for painful osteoarthritis of the lateral compartment of the knee that was associated with a valgus deformity. The patients were followed for two to seventeen years (average, 9.4 years). Twenty-four knees (77 per cent) had either no pain or only occasional mild pain at the last evaluation. Six knees had moderate pain and one, severe pain. Six knees required a subsequent total knee arthroplasty at an average of 9.8 years after the osteotomy. No patient had an infection or non-union. Osteotomy of the proximal part of the tibia is a reasonable method of treating unicompartmental degenerative arthritis in a knee with a valgus deformity. Although some patients with as much as 20 degrees of anatomical valgus deformity obtained a good result in this series, osteotomy in the supracondylar region of the femur is probably preferable if the valgus angulation exceeds 12 degrees or if the tilt of the tibial articular surface that will result from the surgery will exceed 10 degrees. Correction beyond the normal 5 to 7 degrees of valgus angulation to zero degree of anatomical tibiofemoral alignment is recommended to prevent recurrence of the valgus deformity and to decrease the load on the lateral tibiofemoral compartment.