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采用内翻截骨术治疗伴有外翻畸形的膝关节骨关节炎。

Treatment of osteoarthritis of the knee with valgus deformity by means of varus osteotomy.

作者信息

Marin Morales L A, Gomez Navalon L A, Zorrilla Ribot P, Salido Valle J A

机构信息

Department of Orthopedic Surgery, Complejo Hospitalario Ciudad Real, Spain.

出版信息

Acta Orthop Belg. 2000 Jun;66(3):272-8.

Abstract

Nineteen cases of osteoarthritis of the knee with valgus deformity in 17 patients were treated by femoral supracondylar varus osteotomy (17 cases) or by high tibial varus osteotomy (2 cases) over the last 15 years. Fixation was performed using a 95 degrees AO blade-plate in 13 of the femoral osteotomies and a straight plate in the other four. The mean follow-up time was 6.5 years. The valgus deformity was idiopathic in 14 cases, secondary to rheumatoid arthritis in 2 cases and to tibial valgus in one case. The Hospital for Special Surgery (HSS) score was used to evaluate the clinical results: nearly 75% were excellent or good. The causes related to poor results are analyzed regarding indication and surgical technique. It appears that varus osteotomy is an effective procedure for the treatment of osteoarthritis of the knee with valgus deformity, above all in order to alleviate pain, although the operation requires precision, and correct selection of patients is of prime importance.

摘要

在过去15年中,对17例患有膝外翻畸形的膝骨关节炎患者的19个膝关节病例进行了治疗,其中17例行股骨髁上内翻截骨术,2例行高位胫骨内翻截骨术。13例股骨截骨术中使用95°AO髁钢板固定,另外4例使用直板固定。平均随访时间为6.5年。14例膝外翻畸形为特发性,2例继发于类风湿关节炎,1例继发于胫骨外翻。采用特殊外科医院(HSS)评分评估临床结果:近75%为优或良。针对手术指征和手术技术分析了疗效不佳的相关原因。内翻截骨术似乎是治疗伴有膝外翻畸形的膝骨关节炎的有效方法,尤其是为了缓解疼痛,尽管该手术需要精确操作,且正确选择患者至关重要。

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