Trauma Department, Hanover Medical School (MHH), Carl-Neuberg-Strasse 1, 30625 Hanover, Germany.
Knee Surg Sports Traumatol Arthrosc. 2010 Oct;18(10):1328-33. doi: 10.1007/s00167-009-1020-9. Epub 2009 Dec 24.
High tibial osteotomy is an established technique for the treatment of varus malaligned knees. This study analyses the difference between the amount of correction in the preoperative planning and the postoperative result. Furthermore, it compares the difference of the accuracy between open-wedge osteotomy and closed-wedge osteotomy. About 61 patients were either treated with open-wedge or closed-wedge high tibial osteotomy. Preoperative planning and postoperative analysis were performed with a special planning software. The influence of operative technique, aetiology, age, number of previous surgeries, amount of correction and accuracy of the correction compared to the preoperative planning were analysed. The overall postoperative mechanical axis differed form preoperative planning by 2.1° ± 1.7°. The accuracy in the open-wedge group (1.7° ± 1.6°) was significantly higher than in the closed-wedge group (2.6° ± 1.8°; P = 0.038). In patients with congenital varus deformity, the accuracy of the correction was significantly higher than in patients with post-traumatic deformity. The authors recommend open-wedge technique in combination with fixed-angle plates for high tibial osteotomy.
胫骨高位截骨术是一种治疗内翻畸形膝关节的成熟技术。本研究分析了术前规划与术后结果之间的矫正量差异。此外，还比较了开放式楔形截骨术和闭合式楔形截骨术之间的准确性差异。大约 61 名患者接受了开放式楔形或闭合式楔形胫骨高位截骨术。使用特殊的规划软件进行术前规划和术后分析。分析了手术技术、病因、年龄、既往手术次数、矫正量和与术前规划相比的矫正准确性的影响。术后机械轴与术前规划相比平均偏差 2.1°±1.7°。开放式楔形组（1.7°±1.6°）的准确性明显高于闭合式楔形组（2.6°±1.8°；P=0.038）。在先天性内翻畸形患者中，矫正的准确性明显高于创伤后畸形患者。作者建议在胫骨高位截骨术中采用开放式楔形技术并结合使用固定角度钢板。
