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[胫股角变化对穹窿截骨术结果的影响]

[The effect of tibiofemoral angle changes on the results of dome osteotomy].

作者信息

Kerimoğlu Servet, Cavuşoğlu Sonay, Turhan Ahmet Uğur

机构信息

Department of Orthopedics and Traumatology (Ortopedi ve Travmatoloji Anabilim Dali), Medicine Faculty of Karadeniz Technical University, Trabzon, Turkey.

出版信息

Acta Orthop Traumatol Turc. 2008 Mar-Apr;42(2):75-9.

Abstract

OBJECTIVES

We investigated the effect of tibiofemoral angle changes on the results of dome osteotomy in patients with medial compartment osteoarthritis of the knee.

METHODS

The study included 23 knees of 22 patients (15 women, 7 men; mean age 60 years; range 37 to 73 years) who underwent high tibial dome osteotomy for medial compartment osteoarthritis. A simple modified Charnley external fixator was used for stabilization of the osteotomy. Based on the Ahlback classification, 15 knees had grade I, six knees had grade II, and two knees had grade III osteoarthritis. The patients were evaluated in three groups based on the postoperative tibiofemoral angles obtained; hence, a valgus angle of less than 8 degrees (4 knees), 8 degrees to 12 degrees (10 knees), and greater than 12 degrees (9 knees). Clinical evaluations were made using the American Knee Society scoring system. The mean follow-up period was 5.4 years (range 1 to 10 years).

RESULTS

The mean tibiofemoral angle was 4.4+/-2.9 degrees of varus (range 0 degrees to 10 degrees ) preoperatively, and 11+/-3.8 degrees of valgus (range 5 degrees to 18 degrees ) postoperatively. The mean correction loss at final evaluations was 2.7 degrees . The mean preoperative and postoperative knee scores were 37.7+/-15.8 (range 19 to 77) and 80.2+/-9.2 (range 51 to 93), respectively (p<0.001). The mean functional score increased from 52.3+/-18.8 (range 10 to 80) to 75.6+/-18.5 (range 35 to 100) at final analysis (p<0.001). The knee and functional scores did not differ significantly between three groups of patients having a different range of postoperative tibiofemoral angle (p>0.05).

CONCLUSION

Our results show that the alignment obtained after high tibial osteotomy does not influence knee and functional scores provided that it is within an acceptable range.

摘要

目的

我们研究了胫股角变化对膝关节内侧间室骨关节炎患者穹顶截骨术结果的影响。

方法

该研究纳入了22例患者的23个膝关节(15名女性,7名男性;平均年龄60岁;范围37至73岁),这些患者因膝关节内侧间室骨关节炎接受了高位胫骨穹顶截骨术。使用一种简单改良的Charnley外固定器来稳定截骨术。根据Ahlback分类,15个膝关节为I级,6个膝关节为II级,2个膝关节为III级骨关节炎。根据术后获得的胫股角将患者分为三组;因此,外翻角小于8度(4个膝关节)、8度至12度(10个膝关节)和大于12度(9个膝关节)。使用美国膝关节协会评分系统进行临床评估。平均随访期为5.4年(范围1至10年)。

结果

术前平均胫股角为内翻畸形4.4±2.9度(范围0度至10度),术后为外翻11±3.8度(范围5度至18度)。最终评估时平均矫正丢失为2.7度。术前和术后膝关节平均评分分别为37.7±15.8(范围19至77)和80.2±9.2(范围51至93)(p<0.001)。最终分析时,平均功能评分从52.3±18.8(范围10至80)提高到75.6±18.5(范围35至100)(p<0.001)。术后胫股角范围不同的三组患者之间的膝关节和功能评分无显著差异(p>0.05)。

结论

我们的结果表明,高位胫骨截骨术后获得的对线只要在可接受范围内,就不会影响膝关节和功能评分。

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