Morphological changes in the tibiofibular joint following open wedge high tibial osteotomy

Morphological changes in the tibiofibular joint following open wedge high tibial osteotomy
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DOI：
10.1016/j.knee.2020.01.014
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发表时间：
2020-06-01
期刊：
KNEE
影响因子：
1.9
通讯作者：
Ohnishi, Kazutomo
Ohnishi, Kazutomo
中科院分区：
医学4区
文献类型：
--
作者：
Gomi, Noriyuki;Chikaishi, Nobuhiro;Ohnishi, Kazutomo

文献摘要

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背景：探讨开放性胫骨高位楔形截骨术(OWHTO)后胫腓关节的形态变化。观察指标包括站立股胫角(ETA)、机械轴线(%MA)、矫正胫骨角度、距胫骨关节面(T)和腓骨头(F)的距离(D)和角度(A；近端、远端)、近端胫腓关节(PTFJ)骨关节炎(OA)的发病情况和与胫腓关节相关的并发症。结果：ETA由181.1°改善到168.8°，MA由28.7°改善到68.7°，胫骨矫正角度平均为10.4°。近端TFD由术前的9.4 mm恢复到术中的7.8min。腓骨小头向上移位1.6 mm，胫骨近端股骨角(TFA)向外翻方向移动约10度，由82.5度移至92.4度。然而，远端TFD或TFA没有明显变化。PTFJ骨关节炎57例(14.7%)，膝关节后外侧疼痛11例(2.8%)。结论：OWHTO术后增加了PTFJ的负荷。在极少数情况下，这会导致疼痛，因此是医生应该意识到的并发症。(C)2020爱思唯尔B.V.保留所有权利。
Background: To investigate the morphological changes in the tibiofibular joint following open wedge high tibial osteotomy (OWHTO).Methods: We studied 397 joints in 341 patients. Standing femorotibial angle (ETA), %mechanical axis (%MA), corrected tibial angle, distance (D) to tibial joint surface (T) and fibular head (F) and angle (A; proximal, distal), proximal tibiofibular joint (PTFJ) osteoarthritis (OA) onset, and tibiofibular joint-related complications were the parameters assessed.Results: ETA improved from 181.1 degrees to 168.8 degrees and %MA from 28.7 to 68.7, whereas the mean tibia corrected angle was 10.4 degrees. Proximal TFD changed from 9.4 mm preoperatively to 7.8 min during the investigation. The fibular head was displaced 1.6 mm upwards, and proximal tibial femoral angle (TFA) moved approximately 10 degrees in the valgus direction from 82.5 degrees to 92.4 degrees. However, no significant changes were noted for the distal TFD or TFA. PTFJ OA was observed in 57 cases (14.7%), and lateroposterior knee pain in 11 cases (2.8%). Additional resection of the fibula was performed in cases with marked pain.Conclusions: With OWHTO, increased load is placed on the PTFJ postoperatively. In rare cases, this can cause pain and is therefore a complication that physicians should be aware of. (C) 2020 Elsevier B.V. All rights reserved.