O3264 LONG-TERM RESULTS OF PROXIMAL TIBIAL OSTEOTOMY
O3264 LONG-TERM RESULTS OF PROXIMAL TIBIAL OSTEOTOMY
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O3264 胫骨近端截骨术的长期结果
DOI：
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发表时间：
2004
期刊：
影响因子：
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通讯作者：
S. Kazai
中科院分区：
文献类型：
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作者：
M. Papp;L. R—de;S. Kazai
目的：外侧闭合楔形胫骨高位截骨术（CWO）的短期结果在80-90%的患者中令人满意，但CWO的结果显示随着时间的推移而稳定下降。我们评估截骨术的结果，以确定生存率，并确定与截骨术生存相关的风险因素。方法：1986年1月1日之间。1991年12月31日113例患者接受了CWO。我们可以评价54例患者（男31例，女23例）58次手术。手术时平均年龄为57.6（31-69）岁，平均随访时间为12.2（10-15）年。使用寿命表生存率方法，估计失效概率作为时间的函数。采用线性相关、单因素和多因素逐步回归方法进行统计分析。结果：使用寿命表估计的失效生存率，CWO的5年生存概率为91.3%，10年生存概率为72.5%。年龄、术前内翻畸形和活动范围不能保证长期生存（线性相关）。单因素和多因素逐步回归分析显示，超重、内侧间室III度软骨软化、既往腰椎切除术和外翻矫正不充分（FTA）是CWO的危险因素。结论：对危险因素的分析表明，仔细选择患者可以提高CWO的长期生存率。
Aims: Short-term results of lateral closing wedge high tibial osteotomy (CWO) is satisfactory in 80–90% of patients but the results of CWO shows steady decline over time. We evaluated results of osteotomies to determine survivorship and to identify risk factors associated with survival of the osteotomies. Methods: Between 01.01.1986. and 31.12.1991. 113 patients have undergone CWO. We could evaluated 54 patients (31 men and 23 women) with 58 operations. The average age at operation was 57.6 (31–69) years and the mean follow-up was 12.2 (10–15) years. The probability of failure was estimated as a function of time, with use of the Life-table survivorship method. The linear correlation, uni and multivariate Stepwise regression method were used for statistical analysis. Results: Using the Life-table survivorship estimate of failure, the probability of survival for CWO was 91.3% at 5 years and 72.5% at 10 years. An age, preoperative varus deformity and range of movement have not insuenced long term survivorship (linear correlation). Uni and multivariate Stepwise regression showed, that overweight, grade III chondromalacia in medial compartment, previous menisectomy and insufþcient valgus correction (FTA Conclusions: Analysis of risk factors suggests that careful patient selection can improve long term survivorship of CWO.