New angle measurement device to control the posterior tibial slope angle in medial opening wedge high tibial osteotomy
New angle measurement device to control the posterior tibial slope angle in medial opening wedge high tibial osteotomy
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新型角度测量装置在胫骨内侧开口楔形高位截骨术中控制胫骨后坡角
DOI：
10.1007/s00402-017-2846-0
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
Akiyama H.
中科院分区：
文献类型：
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作者：
Ogawa H;Matsumoto K;Akiyama H.
简介内侧开口楔形胫骨高位截骨术与胫骨后坡角意外增加有关。我们的目的是评估新型骨撑开角杆在内侧开口楔形高位胫骨截骨术中维持天然胫骨后坡角的有效性。材料和方法分析了 2015 年 3 月至 2016 年 6 月期间因膝骨关节炎接受内侧开口楔形高位胫骨截骨术的 83 名患者的 92 个连续膝盖的数据。前50例（对照组）在不使用骨撑开器角棒的情况下进行截骨，在随后的42例（角棒组）中使用角棒进行截骨。楔形插入角定义为沿楔形垫片后部绘制的线与股骨髁后部切线之间的角度，并通过术前和术后膝关节侧位X光片以及术后计算机断层扫描图像评估胫骨后坡角。结果楔形插入角显示楔形垫片以更直接的水平方向插入。 direction in the angle rod group than in the control group (16.0 ± 8.8° and 23.0 ± 10.0°, respectively,P< 0.001).角棒组术后胫骨后坡角的变化（0.6±1.6°）明显小于对照组（3.2±3.2°；P<0.0001）。角度棒组有 1 例（2.4%）出现胫骨后坡角变化 > 3°（异常值），而对照组有 27 例（54.0%）。结论在我们的新型骨撑开角棒的帮助下直接水平插入楔形垫片比传统方法更好地保持了自然的胫骨后坡角。
IntroductionMedial opening wedge high tibial osteotomy has been associated with an unintentional increase in the posterior tibial slope angle. We aimed to evaluate the effectiveness of a novel bone spreader angle rod to maintain the native posterior tibial slope angle in medial opening wedge high tibial osteotomy.Materials and methodsData from 92 consecutive knees in 83 patients who underwent medial opening wedge high tibial osteotomy for knee osteoarthritis between March 2015 and June 2016 were analysed. The osteotomy was performed without the use of a bone spreader angle rod in the first 50 cases (control group) and with the use of the angle rod in the subsequent 42 cases (angle rod group). The wedge insertion angle, defined as the angle between a line drawn along the posterior aspect of the wedge spacer and a line tangential to the posterior aspect of the femoral condyles, and the posterior tibial slope angle were evaluated on pre- and postoperative lateral knee radiographs and postoperative computed tomography images.ResultsWedge insertion angle showed that wedge spacers were inserted in a more direct horizontal direction in the angle rod group than in the control group (16.0 ± 8.8° and 23.0 ± 10.0°, respectively,P< 0.001). The pre- to postoperative change in posterior tibial slope angle was significantly smaller in the angle rod group (0.6 ± 1.6°) compared to that in the control group (3.2 ± 3.2°;P< 0.0001). A change of posterior tibial slope angle > 3° (outlier) was identified in 1 case (2.4%) in the angle rod group compared to 27 cases in the control group (54.0%).ConclusionsThe direct horizontal insertion of wedge spacers with the assistance of our novel bone spreader angle rod maintains the native posterior tibial slope angle better than conventional methods.Level of evidenceIV.