High tibial osteotomy for unloading osteochondral defects in the medial compartment of the knee
High tibial osteotomy for unloading osteochondral defects in the medial compartment of the knee
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DOI：
10.1177/0363546508315471
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发表时间：
2008-05-01
影响因子：
4.8
通讯作者：
Higgins, Laurence
中科院分区：
文献类型：
--
作者：
Mina, Curtis;Garrett, William E.;Higgins, Laurence
背景：胫骨高位截骨术是治疗症状性内侧单间室软骨退变的一种成熟方法。虽然几项结局研究的结果已导致广泛实施的术后目标对线为8 °至10 °外翻，但没有文献说明患者特定的测量值，如体重、基线几何形状和内侧软骨缺损尺寸。此外，还缺乏文献支持理想的目标对准时，使用胫骨高位截骨术卸载孤立的chonediculateddefects.Purpose：为了确定这些患者的具体因素和理想的术后alignment.Study Design：Controlled laboratory study.Methods：胫骨高位截骨术进行了8人尸体膝关节和固定与动态外固定器。使用固定器改变胫股对线，从12度外翻到10度内翻。在每次对齐时，记录力、接触面积和压力分布。结果：随着胫股关节对线由内翻变为外翻，我们发现内侧接触压力降低（P <0.001），内侧接触面积减小（P <0.001）。
Background: High tibial osteotomy is a well-established method for the treatment of symptomatic medial unicompartmental cartilage degeneration. While the findings of several outcome studies have led to the widely practiced postoperative goal alignment of 8 degrees to 10 degrees of valgus, there exists no literature to account for patient-specific measurements such as body weight, baseline geometry, and medial chondral defect size. Furthermore, there is a lack of literature to support the ideal goal alignment when using high tibial osteotomy to unload isolated chondral defects.Purpose: To identify a relationship between these patient-specific factors and the ideal postoperative alignment.Study Design: Controlled laboratory study.Methods: High tibial osteotomy was performed on 8 human cadaveric knees and was fixed with a dynamic external fixator. The fixator was used to vary the tibiofemoral alignment from 12 degrees valgus to 10 degrees varus. At each alignment, force, contact area, and pressure distribution were recorded. This pattern was repeated for a range of applied loads (0.8-1.8 x ideal body weight) and across a range of medial chondral defect sizes (10-20 cm).Results: As tibiofemoral alignment was shifted from varus to valgus alignment, we found a decrease in medial contact pressure (P < .001) and a decrease in medial contact area (P