Yanasse Ricardo Hideki, Cavallari Carlos Eduardo, Chaud Felipe Lourenço, Hernandez Arnaldo José, Mizobuchi Roberto Ryuiti, Laraya Marcos Henrique
Institute of Orthopedics and Traumatology, School of Medicine, Universidade de São Paulo, São Paulo, Brazil.
Sao Paulo Med J. 2009 Jan;127(1):34-9. doi: 10.1590/s1516-31802009000100008.
In the past, changes in tibial slope were not considered when planning or evaluating osteotomies, and success in high tibial osteotomy was related to the alignment and amount of femorotibial angular correction. The aim here was to measure changes in tibial slope after medial opening wedge tibial osteotomy and investigate the effect of tibial slope angle on the clinical results.
Retrospective review study on a series of cases, at the Department of Orthopedics and Traumatology, Faculdade de Medicina de Marília (Famema), Marília, Brazil.
Twenty-eight patients were studied, and a total of thirty-one knees. Lateral roentgenograms of the tibia were used pre and postoperatively to measure the tibial slope based on the proximal tibial anatomical axis. The clinical results were measured using the Lysholm knee score.
There was an average increase in tibial slope angle after surgery of 2.38 degrees (95% confidence interval: +/- 0.73 degrees ). There was no correlation (r = -0.28) between the postoperative Lysholm knee score and the difference in tibial slope angle from before to after surgery (P = 0.13).
Medial opening wedge tibial osteotomy led to a small increase in tibial slope. No significant correlation was found between increased tibial slope and short-term clinical results after high tibial osteotomy. Other clinical studies are needed in order to establish whether extension or flexion osteotomy could benefit patients with medial compartment gonarthrosis.
过去，在计划或评估截骨术时未考虑胫骨斜率的变化，高位胫骨截骨术的成功与股胫角矫正的对线和程度有关。本研究的目的是测量内侧开口楔形胫骨截骨术后胫骨斜率的变化，并探讨胫骨斜率角度对临床结果的影响。
在巴西马利利亚医学院（Famema）骨创伤科对一系列病例进行回顾性研究。
对28例患者共31个膝关节进行研究。术前和术后使用胫骨的外侧X线片，基于胫骨近端解剖轴测量胫骨斜率。使用Lysholm膝关节评分评估临床结果。
术后胫骨斜率角度平均增加2.38度（95%置信区间：±0.73度）。术后Lysholm膝关节评分与手术前后胫骨斜率角度的差异之间无相关性（r = -0.28）（P = 0.13）。
内侧开口楔形胫骨截骨术导致胫骨斜率略有增加。高位胫骨截骨术后胫骨斜率增加与短期临床结果之间未发现显著相关性。需要进行其他临床研究以确定伸展或屈曲截骨术是否对内侧间室膝骨关节炎患者有益。
