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胫骨高位外翻截骨术后7至19年,内侧间室骨关节炎膝关节软骨下骨骨硬化程度降低。

Decrease of osteosclerosis in subchondral bone of medial compartmental osteoarthritic knee seven to nineteen years after high tibial valgus osteotomy.

作者信息

Takahashi Shigenori, Tomihisa Koshino, Saito Tomoyuki

机构信息

Department of Orthopaedic Surgery, Yokohama City University, School of Medicine, Yokohama, Japan.

出版信息

Bull Hosp Jt Dis. 2002;61(1-2):58-62.

Abstract

Osteosclerosis of the subchondral bone was measured by densitometer on plain radiographs in 55 medial compartmental osteoarthritic knees of 40 patients who were treated with high tibial valgus osteotomy for correction of varus deformity. The ratio of the osteosclerosis value of the medial side of the knee to that of the lateral side (Medial/Lateral ratio) was calculated and used as a parameter. The Medial/Lateral ratio of osteosclerosis decreased rapidly within three years after osteotomy at the reference points of the femur and the tibia. Even 7 to 19 years after osteotomy, a decrease of the ratio was noted in 16 knees with a standing femorotibial angle (FTA) less than 168 degrees (12 degrees of anatomical valgus angulation). This was interpreted to mean that osteosclerosis of the medial condyle decreased compared with that of the lateral condyle after overcorrection of varus deformity. In the cases of more than 7 years after high tibial osteotomy, a positive straight regression line was drawn by calculation between Medial/Lateral ratio and postoperative limb alignment expressed by standing femorotibial angle, with coefficient of correlation (gamma) of 0.295 (p < 0.01).

摘要

对40例接受高位胫骨外翻截骨术以矫正内翻畸形的患者的55个内侧间室骨关节炎膝关节,通过普通X线片上的骨密度仪测量软骨下骨的骨硬化情况。计算膝关节内侧骨硬化值与外侧骨硬化值的比值(内侧/外侧比值)并将其用作参数。在股骨和胫骨的参考点处,截骨术后三年内骨硬化的内侧/外侧比值迅速下降。即使在截骨术后7至19年,在站立时股胫角(FTA)小于168度(解剖学外翻角12度)的16个膝关节中也观察到该比值下降。这被解释为内翻畸形过度矫正后内侧髁的骨硬化与外侧髁相比有所减轻。在高位胫骨截骨术后7年以上的病例中,通过计算得出内侧/外侧比值与以站立股胫角表示的术后肢体对线之间呈正直线回归线,相关系数(γ)为0.295(p<0.01)。

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