Opening-Wedge High Tibial Osteotomy with a Locked Low-Profile Plate Surgical Technique
Opening-Wedge High Tibial Osteotomy with a Locked Low-Profile Plate Surgical Technique
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DOI：
10.2106/jbjs.j.00188
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发表时间：
2010-09-01
影响因子：
5.3
通讯作者：
Kolb, Klaus
中科院分区：
文献类型：
--
作者：
Kolb, Werner;Guhlmann, Hanno;Kolb, Klaus
背景：胫骨高位截骨术被认为是治疗膝关节内侧间室骨关节炎的有效方法。本前瞻性研究的目的是评估开放楔形胫骨高位截骨与锁定钢板fixation.METHODS的短期结果：从2002年9月至2005年11月，51例连续内侧开放楔形胫骨高位截骨。首次手术时患者的平均年龄为49岁。术前和术后分析的因素包括胫股间室关节炎的分级（Ahlback影像学分级），解剖胫股角，髌骨高度，医院的特殊外科评分系统评分，Lysholm和Gillquist膝关节评分。51例截骨术中有50例在平均12.9周（范围，8至16周）后愈合，无需植骨。一名62岁的吸烟患者发生骨不连。术后平均胫股角为90 °外翻。49例患者平均随访52个月。在最近一次随访时，特殊外科医院评分系统的平均评分为86分。28名患者（57%）的评级为极好，12名（24%）为良好，4名（8%）为一般，5名（10%）为差。Lysholm和Gillquist膝关节评分量表的平均得分为83分。根据这些评分，9名患者（18%）的结局为优，31名患者（63%）为良，3名患者（6%）为一般，6名患者（12%）为差。四个膝关节失败后，平均为36 months.CONCLUSIONS：我们的研究结果表明，开放楔形胫骨高位截骨术与锁定钢板固定允许一个正确的外翻角，以实现良好的短期结果。证据水平：治疗水平IV。有关证据等级的完整描述，请参阅作者说明。原始摘要引文：“使用锁定低切迹钢板进行开放楔形胫骨高位截骨术”（2009; 91：2581 - 8）。
BACKGROUND: High tibial osteotomy has been recognized as a beneficial treatment for osteoarthritis of the medial compartment of the knee. The purpose of this prospective study was to assess the short-term results of opening-wedge high tibial osteotomies with locked plate fixation.METHODS: From September 2002 to November 2005, fifty-one consecutive medial opening-wedge high tibial osteotomies were performed. The mean age of the patients at the time of the index operation was forty-nine years. The preoperative and postoperative factors analyzed included the grade of arthritis of the tibiofemoral compartment (the Ahlback radiographic grade), the anatomic tibiofemoral angle, patellar height, the Hospital for Special Surgery rating system score, and the Lysholm and Gillquist knee score.RESULTS: Postoperatively, one superficial wound infection occurred. Fifty of the fifty-one osteotomies healed after an average period of 12.9 weeks (range, eight to sixteen weeks) without bone grafts. A nonunion developed in a sixty-two-year-old patient who was a cigarette smoker. The average postoperative tibiofemoral angle was 90 of valgus. Forty-nine patients were followed for a mean of fifty-two months. The average score on the Hospital for Special Surgery rating system was 86 points at the time of the most recent follow-up. The rating was excellent in twenty-eight patients (57%), good in twelve (24%), fair in four (8%), and poor in five (10%). The average score on the Lysholm and Gillquist knee-scoring scale was 83 points. According to these scores, the outcome was excellent in nine patients (18%), good in thirty-one (63%), fair in three (6%), and poor in six (12%). Four knees failed after an average of thirty-six months.CONCLUSIONS: Our results suggest that an opening-wedge high tibial osteotomy with locked plate fixation allows a correct valgus angle to be achieved with good short-term results.LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.ORIGINAL ABSTRACT CITATION: "Opening-Wedge High Tibial Osteotomy with a Locked Low-Profile Plate" (2009;91:2581-8).