Short-Term Outcomes after High Tibial Osteotomy Aimed at Neutral Alignment Combined with Arthroscopic Centralization of Medial Meniscus in Osteoarthritis Patients
Short-Term Outcomes after High Tibial Osteotomy Aimed at Neutral Alignment Combined with Arthroscopic Centralization of Medial Meniscus in Osteoarthritis Patients
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DOI：
10.1055/s-0041-1731738
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发表时间：
2021-07-14
影响因子：
1.7
通讯作者：
Koga, Hideyuki
中科院分区：
文献类型：
--
作者：
Katagiri, Hiroki;Nakagawa, Yusuke;Koga, Hideyuki
本研究旨在改善开放楔形胫骨高位截骨术(OWHTO)的远期疗效；介绍了将OWHTO中性对齐和关节镜下中央化相结合的半月板挤压手术方法。本研究评估了患者报告的短期结果指标，即OWHTO术后步行疼痛的患者主观满意度评分和数字评定量表(NRS)，旨在为突出的内侧半月板在关节镜下和不在关节镜下进行中性对准。对50例原发OWHTO患者进行了回顾性分析。在应用排除标准后，39名患者被纳入分析。中心组包括21例膝关节骨性关节炎患者，行关节镜下半月板正中化术，对照组18例，仅行半月板正中化术。从术前到术后3年记录患者的主观满意度评分和行走疼痛的NRS。根据Lysholm膝关节评分、国际膝关节文件委员会主观评分和膝关节骨关节炎结果评分，对最新数据(术后至少2年)进行回顾。术后2年测量关节间隙宽度和关节线合合角的变化。患者的人口统计数据也被复习了。集中组中有一名患者发生了浅表手术部位感染。两组患者术后1年主观满意度和行走疼痛NRS评分逐渐提高，并持续到术后3年，两组间差异无统计学意义。单纯采用中性对齐的OWHTO和采用关节镜下中心定位的OWHTO的患者报告的结果从术前到术后3年的过程显示出相似的趋势。
The study aimed to improve the long-term outcomes of open-wedge high tibial osteotomy (OWHTO); procedures combining OWHTO aimed at neutral alignment and arthroscopic centralization for meniscal extrusion have been introduced. The present study evaluated short-term patient-reported outcome measures; namely, the patient subjective satisfaction scores and Numeric Rating Scale (NRS) for walking pain after OWHTO aimed at neutral alignment with and without arthroscopic centralization for an extruded medial meniscus. A retrospective review of 50 primary OWHTO patients was conducted. Thirty-nine patients were included in the analysis after applying the exclusion criteria. The centralization group included 21 patients with knee osteoarthritis patients who underwent the OWHTO with arthroscopic meniscal centralization, while the control group included 18 patients who underwent OWHTO alone. The patient subjective satisfaction scores and NRS for walking pain were recorded at outpatient visits from before surgery to 3 years after surgery. In terms of the Lysholm knee scale, International Knee Documentation Committee subjective score, and Knee Osteoarthritis Outcome Score, the latest data (at least 2 years after surgery) were reviewed. Radiographic changes in joint space width and joint line congruence angle were measured 2 years postoperatively. Patient demographic data were also reviewed. One patient in the centralization group experienced a superficial surgical site infection. The patient subjective satisfaction and NRS scores for walking pain gradually improved by 1 year after surgery and were sustained until 3 years after surgery in both groups, with no significant difference between the groups. The course of patient-reported outcome measures from before surgery to 3 years after surgery for solely OWHTO aimed at neutral alignment and OWHTO aimed at neutral alignment with arthroscopic centralization showed the similar trends.