Young Claire F, Bourne Robert B, Rorabeck Cecil H
Department of Orthopaedic Surgery, London Health Sciences Centre-University Hospital, London, Ontario, Canada.
J Arthroplasty. 2008 Apr;23(3):371-5. doi: 10.1016/j.arth.2007.02.019. Epub 2007 Nov 26.
Tibial tubercle osteotomy (TTO) is a recognized technique for improving exposure when performing total knee arthroplasty surgery. Forty-two patients were reviewed at a mean of 8 years after TTO. Preoperatively, mean extension was 8 degrees +/- 14 degrees , mean flexion 74 degrees +/- 30 degrees , and Knee Society score 73 +/- 37. At latest follow-up, mean extension was 4 degrees +/- 15 degrees , mean flexion 91 degrees +/- 22 degrees , and Knee Society score 124 +/- 42.6 (P < or = .0001). Seventy-three percent of patients had an excellent/good score at latest follow-up. Twenty-five percent of patients experienced no extensor lag, and 66% of extensor lags had resolved within 6 months. Mean time for osteotomy union was 14 weeks. In this series, TTO performed to enhance surgical exposure did not adversely affect the outcome after total knee arthroplasty but resulted in serious complications in 5% of patients.
胫骨结节截骨术（TTO）是全膝关节置换手术中一种公认的用于改善手术暴露的技术。对42例行TTO手术的患者进行了平均8年的随访。术前，平均伸直角度为8°±14°，平均屈曲角度为74°±30°，膝关节协会评分73±37。在最近一次随访时，平均伸直角度为4°±15°，平均屈曲角度为91°±22°，膝关节协会评分124±42.6（P≤0.0001）。73%的患者在最近一次随访时评分为优/良。25%的患者没有伸肌滞后，66%的伸肌滞后在6个月内得到缓解。截骨愈合的平均时间为14周。在本系列研究中，为增强手术暴露而进行的TTO并未对全膝关节置换术后的结果产生不利影响，但5%的患者出现了严重并发症。
