Magyar G, Ahl T L, Vibe P, Toksvig-Larsen S, Lindstrand A
Department of Orthopaedics, University Hospital, Lund, Sweden.
J Bone Joint Surg Br. 1999 May;81(3):444-8. doi: 10.1302/0301-620x.81b3.8925.
We describe the results of 50 operations carried out on 46 patients with medial osteoarthritis of the knee of Ahlbäck grade 1 to 3. Patients were randomised either to a closed-wedge high tibial osteotomy (HTO) or an open-wedge procedure based on the hemicallotasis technique (HCO). Their median age was 55 years (38 to 68). The preoperative median hip-knee-ankle (HKA) angle was 171 degrees (164 to 176) in the HTO group and 173 degrees (165 to 179) in the HCO group. After six weeks, the median HKA angle was 185 degrees (176 to 194) in the HTO group and 184 degrees (181 to 188) in the HCO group. In the HTO group, seven patients were within the range of 182 degrees to 186 degrees compared with 21 in the HCO group (p < 0.001). One year later, ten HTO patients were within this range while the HKA angulation in the HCO group was unchanged. At two years the numbers were 11 and 18, respectively. We evaluated the clinical results on the Hospital for Special Surgery, Lysholm and Wallgren-Tegner activity scores, and patients completed part of the Nottingham Health Profile questionnaire. An impartial observer at the two-year follow-up concluded that all scores had improved, but found no clinical differences between the groups.
我们描述了对46例Ahlbäck 1至3级膝关节内侧骨关节炎患者进行的50例手术的结果。患者被随机分为闭合楔形高位胫骨截骨术（HTO）组或基于半骺延长技术的开放楔形手术（HCO）组。他们的年龄中位数为55岁（38至68岁）。HTO组术前髋-膝-踝（HKA）角中位数为171度（164至176度），HCO组为173度（165至179度）。六周后，HTO组HKA角中位数为185度（176至194度），HCO组为184度（181至188度）。在HTO组中，7例患者的HKA角在182度至186度范围内，而HCO组有21例（p<0.001）。一年后，10例HTO患者在此范围内，而HCO组的HKA角度没有变化。两年时，两组人数分别为11例和18例。我们根据特殊外科医院、Lysholm和Wallgren-Tegner活动评分评估了临床结果，患者完成了诺丁汉健康概况问卷的部分内容。在两年随访时，一名公正的观察者得出结论，所有评分均有所改善，但两组之间没有临床差异。
