Ribeiro Cristiano Hossri, Severino Nilson Roberto, Cury Ricardo de Paula Leite, de Oliveira Victor Marques, Avakian Roger, Ayhara Tatsuo, de Camargo Osmar Pedro Arbix
Knee Surgery Division, Department of Orthopaedics and Traumatology, Faculdade de Ciências Médicas, Irmandade da Santa Casa de Misericórdia de São Paulo (FCMSCSP), Brazil.
Knee. 2009 Oct;16(5):366-70. doi: 10.1016/j.knee.2009.01.007. Epub 2009 Feb 27.
Varus deformity of the knee is a determining factor in the development of osteoarthrosis of the medial compartment. Open wedge osteotomy corrects the deformity and has quickly become popular due to the fact that the surgical technique can be easily reproduced, it spares loss of bone tissue in the metaphysiary region, and it does not require muscle dissection, reducing the risk of lesion of the fibular nerve. The objective of this study was to evaluate the characteristics of a new fixation implant (Anthony-K plate - France Bloc S.A, CE n0499, ISO 9001, EN 46001), in terms of its clinical improvement, correction of the deformity, and slope alteration. Twenty adult patients with varus deformity were evaluated, and submitted to open wedge high tibial osteotomy using the Anthony plate, between October 2004 and November 2006. The varus deformity was corrected in all cases, and there was a significant increase in the Lysholm score. Correlation analysis has shown that the greater the preoperative varus deformity, the larger the opening wedge used. Also, the greater the initial posterior tibial slope, the larger the final posterior tibial slope (p=0.0168). There were no complications. The Anthony plate can be considered an alternative in the treatment of medial osteoarthrosis of the varus knee, enabling the correction of the deformity and improvement of the clinical picture. It occurs an increase in posterior tibial slope, similar to that observed with other fixation materials. More studies with the Anthony plate are necessary, after these encouraging results.
膝关节内翻畸形是内侧间室骨关节炎发展的一个决定性因素。开放楔形截骨术可矫正畸形,且由于该手术技术易于重复操作、能避免干骺端区域骨组织丢失、无需肌肉剥离从而降低腓总神经损伤风险,因而迅速受到欢迎。本研究的目的是评估一种新型固定植入物(安东尼 - K钢板 - 法国Bloc S.A公司,CE编号0499,ISO 9001,EN 46001)在临床改善、畸形矫正及斜率改变方面的特性。2004年10月至2006年11月期间,对20例患有内翻畸形的成年患者进行了评估,并使用安东尼钢板行开放楔形高位胫骨截骨术。所有病例的内翻畸形均得到矫正,Lysholm评分显著提高。相关性分析表明,术前内翻畸形越大,使用的开放楔形角度越大。此外,初始胫骨后倾角越大,最终胫骨后倾角越大(p = 0.0168)。未出现并发症。安东尼钢板可被视为治疗内翻膝关节内侧骨关节炎的一种替代方法,能够矫正畸形并改善临床表现。胫骨后倾角会增加,与使用其他固定材料时观察到的情况类似。在取得这些令人鼓舞的结果之后,有必要对安东尼钢板进行更多研究。