Bonnin M, Chambat P
Clinique Sainte Anne Lumière, Lyon, France.
Orthopade. 2004 Feb;33(2):135-42. doi: 10.1007/s00132-003-0586-z.
In young and active patients, closing-wedge high tibial osteotomies are reliable procedures in the treatment of osteoarthritis of the medial compartment of the knee. This has been consistently shown throughout the last 2 decades. The present study analyzes the long-term results of 217 patients after an average of 9 years and compares them to the results in the literature. Besides correction of the alignment, other prognostic factors such as the patients' age, overweight, the preoperative degree of osteoarthritis, but also a newer prognostic factor described by the Lyon knee school have been evaluated. The authors found that the "tibial bone varus angle" might be helpful to differentiate between a bony deformity of the proximal tibia, amenable to correction by osteotomy, and a secondary bony erosion of the medial tibial plateau, with a worse prognosis.
对于年轻且活跃的患者,闭合楔形高位胫骨截骨术是治疗膝关节内侧间室骨关节炎的可靠手术方法。在过去20年中,这一点已得到持续证实。本研究分析了217例患者平均9年后的长期结果,并将其与文献中的结果进行比较。除了对线矫正外,还评估了其他预后因素,如患者年龄、超重情况、术前骨关节炎程度,以及里昂膝关节学派描述的一个较新的预后因素。作者发现,“胫骨内翻角”可能有助于区分近端胫骨的骨畸形(可通过截骨术矫正)和内侧胫骨平台的继发性骨侵蚀,后者预后较差。