Five- to ten-year outcome following medial opening-wedge high tibial osteotomy with rigid plate fixation in combination with an artificial bone substitute
Five- to ten-year outcome following medial opening-wedge high tibial osteotomy with rigid plate fixation in combination with an artificial bone substitute
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DOI：
10.1302/0301-620x.96b3.32525
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发表时间：
2014-03-01
影响因子：
4.6
通讯作者：
Kusayama, Y.
中科院分区：
文献类型：
--
作者：
Saito, T.;Kumagai, K.;Kusayama, Y.
2003年至2007年间，77名患者的99个膝关节接受了开放性楔形胫骨高位截骨术。对78例膝关节内侧室间隔骨关节炎或自发性膝骨性坏死患者行胫骨内侧切开楔形截骨术后，早期稳定内固定联合人工骨替代物对中远期疗效的影响。术后平均随访6.5年(5~10年)。膝关节协会膝关节评分和功能评分分别由术前的49·6分(SD11·4，26~72)和56·6分(SD15·6，5~100)提高到术后随访时的88·1分(SD12·5，14~100)和89·4分(SD15·6，5~100)(p<；0.001)。年龄在70岁和70岁的患者之间无显著差异。平均站立角度由术前181.7°(SD2.7°，175°~185°)显著矫正至术后1年(169.7°，SD2.4°，164°~175°)和169.6°(SD3.0°，157°~179°)(P=0.69vs1年)。使用稳定的钢板固定系统结合骨替代物的开楔形HTO是一种可靠的手术方法，可提供良好的效果。尽管这种治疗对老年患者来说似乎具有挑战性，但我们的结果强烈表明，结果也同样好。
Between 2003 and 2007, 99 knees in 77 patients underwent opening wedge high tibial osteotomy. We evaluated the effect of initial stable fixation combined with an artificial bone substitute on the mid-to long-term outcome after medial opening-wedge high tibial osteotomy (HTO) for medial compartmental osteoarthritis or spontaneous osteonecrosis of the knee in 78 knees in 64 patients available for review at a minimum of five years (mean age 68 years; 49 to 82). The mean follow-up was 6.5 years (5 to 10). The mean Knee Society knee score and function score improved from 49.6 (SD 11.4, 26 to 72) and 56.6 (SD 15.6, 5 to 100) before surgery to 88.1 (SD 12.5, 14 to 100) and 89.4 (SD 15.6, 5 to 100) at final follow-up (p < 0.001) respectively. There were no significant differences between patients aged = 70 and < 70 years. The mean standing femorotibial angle was corrected significantly from 181.7 degrees (SD 2.7 degrees, 175 degrees to 185 degrees) pre-operatively to 169.7 degrees (SD 2.4 degrees, 164 degrees to 175 degrees) at one year's follow-up (p < 0.001) and 169.6 degrees (SD 3.0 degrees, 157 degrees to 179 degrees) at the final follow-up (p = 0.69 vs one year). Opening-wedge HTO using a stable plate fixation system combined with a bone substitute is a reliable procedure that provides excellent results. Although this treatment might seem challenging for older patients, our results strongly suggest that the results are equally good.