McGill University Health Centre, Montréal, Que., Canada.
Can J Surg. 2010 Aug;53(4):261-7.
Although a previous study showed that anterior opening wedge high tibial osteotomy (HTO) for sagittal plane correction induced no increased strain in the anterior cruciate ligament (ACL), we hypothesized that other ligamentous restraints of the knee may be subjected to increased strain.
We mounted 6 cadaveric knees at 15 degrees flexion in a testing apparatus that provided compressive and anterior loading. We measured the strain in the ACL, posterior (PCL), medial (MCL) and lateral (LCL) ligaments for 6 randomized loading combinations and 3 conditions: intact, after anterior opening wedge HTO with a 5-mm plate and with a 10-mm plate.
The mean ACL strain decreased from 0.84% (standard deviation [SD] 1.50%) at baseline to -6.28% (SD 5.40%) with a 5-mm anterior opening wedge osteotomy and to -6.77% (SD 4.79%) with a 10-mm osteotomy. Stepwise regressions yielded no significant effect of compression, anterior loading or osteotomy on PCL, MCL or LCL strain.
Increasing the posterior slope via HTO did not increase strain in the PCL, MCL or LCL.
尽管之前的一项研究表明，用于矢状面矫正的前开楔形胫骨高位截骨术（HTO）不会增加前交叉韧带（ACL）的张力，但我们假设膝关节的其他韧带约束可能会受到更大的张力。
我们将 6 个尸体膝关节在 15 度屈曲的测试设备上进行了安装，该设备提供了压缩和前向加载。我们测量了 ACL、后交叉韧带（PCL）、内侧（MCL）和外侧（LCL）韧带在 6 种随机加载组合和 3 种情况下的应变：完整、前开楔形 HTO 后（使用 5mm 板）和使用 10mm 板。
ACL 的平均应变从基线时的 0.84%（标准差 [SD] 1.50%）下降到 5mm 前开楔形截骨术时的-6.28%（SD 5.40%）和 10mm 截骨术时的-6.77%（SD 4.79%）。逐步回归显示压缩、前向加载或截骨术对 PCL、MCL 或 LCL 应变均无显著影响。
通过 HTO 增加后斜率不会增加 PCL、MCL 或 LCL 的张力。
