PROXIMAL TIBIAL OSTEOTOMY - A CRITICAL LONG-TERM STUDY OF 87 CASES
PROXIMAL TIBIAL OSTEOTOMY - A CRITICAL LONG-TERM STUDY OF 87 CASES
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DOI：
10.2106/00004623-199302000-00006
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发表时间：
1993-02-01
影响因子：
5.3
通讯作者：
WALLRICHS, SL
中科院分区：
文献类型：
--
作者：
COVENTRY, MB;ILSTRUP, DM;WALLRICHS, SL
对73例膝关节内侧室骨关节病患者进行了87次胫骨外翻截骨术，中位随访时间为10年(3~14年)。对数据进行单变量和多变量统计分析，并进行生存分析。在这些计算中，失败的终点被定义为膝关节置换，并进行了额外的计算，终点被定义为关节置换的表现或拒绝接受关节置换的患者的中度或重度疼痛。评估的许多危险因素中，除了相对重量和角度校正外，没有一个与生存时间有关。截骨术后矫正丢失中位数为1度。如果在手术后一年，外翻角度为8度或以上，或如果患者的体重为理想体重的1.32倍或更少，则术后5年存活的概率至少为90%，10年后存活的概率至少为65%。然而，当体重超过理想体重的1.32倍的患者在一年内外翻角度小于8度时，五年后存活率下降到38%，十年后下降到19%。如果对齐不过度矫正到至少8度外翻角度，并且患者严重超重，则胫骨近端截骨术失败的风险相当大。
Eighty-seven valgus osteotomies of the tibia were performed in seventy-three patients for osteoarthrosis of the medial compartment of the knee; the median follow-up was ten years (range, three to fourteen years). The data were subjected to univariate and multivariate statistical analysis and to survivorship analysis. For these calculations, the end-point of failure was defined as an arthroplasty of the knee, and additional calculations were performed with the end-point defined as the performance of an arthroplasty or moderate or severe pain in patients who had declined an arthroplasty.None of the many risk factors that were evaluated could be found to be associated with the duration of survival, except for relative weight and angular correction. The median loss of correction after the osteotomy was 1 degree. If, at one year after the operation, the valgus angulation was 8 degrees or more, or if the patient's weight was 1.32 times the ideal weight or less, the probability of survival five years thereafter was at least 90 per cent and the probability ten years thereafter was at least 65 per cent. However, when valgus angulation at one year was less than 8 degrees in a patient whose weight was more than 1.32 times the ideal weight, the rate of survival decreased to 38 per cent five years thereafter and to 19 per cent ten years thereafter.There is a considerable risk of failure of a proximal tibial osteotomy if the alignment is not overcorrected to at least 8 degrees of valgus angulation and if the patient is substantially overweight.