Willey Michael, Wolf Brian R, Kocaglu Baris, Amendola Annunziato
Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA.
Iowa Orthop J. 2010;30:55-60.
Debate remains regarding whether knee realignment osteotomy should be performed concomitantly with additional major knee reconstruction procedures or if it should be performed in a staged fashion. The purpose of this study is to analyze complications that occur when distal femoral osteotomy or high tibial osteotomy is performed concomitantly with other significant reconstructive procedures. Thirty-five patients with a minimum of one year follow up were identified. These patients underwent either high tibial or distal femoral osteotomy with concomitant significant additional knee reconstruction which included cartilage resurfacing requiring an arthrotomy, ligament reconstruction, meniscal transplantation, or extensor mechanism realignment requiring tibial tubercle osteotomy. Overall, 13/35 (37%) of these patients suffered at least one major or minor complication. Major complications occurred in 20.0% (7/35) and minor complications occurred in 25.7% (9/35). In conclusion, the rate of complication for combined osteotomy and reconstructive knee surgery is similar to that seen in cases of osteotomy done alone and combined surgery is advocated.
关于膝关节重新排列截骨术是应与其他主要膝关节重建手术同时进行,还是应分阶段进行,仍存在争议。本研究的目的是分析在进行股骨远端截骨术或高位胫骨截骨术的同时进行其他重大重建手术时发生的并发症。确定了35例至少随访一年的患者。这些患者接受了高位胫骨或股骨远端截骨术,同时进行了其他重大的膝关节重建手术,包括需要切开术的软骨表面置换、韧带重建、半月板移植或需要胫骨结节截骨术的伸肌机制重新排列。总体而言,这些患者中有13/35(37%)至少发生了一种主要或次要并发症。主要并发症发生率为20.0%(7/35),次要并发症发生率为25.7%(9/35)。总之,截骨术与膝关节重建手术联合应用的并发症发生率与单独进行截骨术的情况相似,因此主张联合手术。