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膝关节内侧骨关节炎的胫骨近端内侧双平面后结节开放楔形截骨术

Proximal medial tibial biplanar retrotubercle open wedge osteotomy in medial knee arthrosis.

作者信息

Esenkaya Irfan, Unay Koray

机构信息

Department of Orthopaedic and Traumatology Department, Goztepe Research and Training Hospital, Istanbul, Turkey.

出版信息

Knee. 2012 Aug;19(4):416-21. doi: 10.1016/j.knee.2011.03.009. Epub 2011 May 10.

Abstract

The patellar tendon length changes and patella infera occurs in medial open wedge osteotomies. We hypothesized that patellar tendon length in the sagittal plane would not change in a proximal medial tibial biplanar retrotubercle open wedge osteotomy. Proximal medial tibial biplanar retrotubercle open wedge osteotomies were conducted on 23 knees of 22 patients; the mean patient age was 59 ± 7 years (range, 53-69 years). The surgical procedure used had some technical distinctions from those used in literature. The mean follow-up was 37 ± 11 months (range, 19-58 months). Preoperative and postoperative Hospital for Special Surgery Scoring System (HSS) scores, radiological tibial slope, Insall-Salvati, Blackburne-Peel, and Caton indices, femoro-tibial anatomical axis angle, the angle between the femoral condyle and tibial plateau, and the angle between the tibial plateau and tibial axis were measured and compared statistically. Postoperative HSS scores were statistically higher than the preoperative HSS scores. The femoro-tibial axis angle, the angle between the femoral condyle and tibial plateau, and the angle between the tibial plateau and tibial axes decreased significantly. No statistical difference was observed between the preoperative and postoperative Insall-Salvati, Blackburne-Peel, or Caton indices. When we performed proximal medial tibial biplanar retrotubercle open wedge osteotomy, clinical and radiological recovery was observed but patellar height did not change.

摘要

在胫骨内侧开放性楔形截骨术中,髌腱长度会发生改变并出现低位髌骨。我们推测,在胫骨近端内侧双平面后结节开放性楔形截骨术中,矢状面的髌腱长度不会改变。对22例患者的23个膝关节进行了胫骨近端内侧双平面后结节开放性楔形截骨术;患者平均年龄为59±7岁(范围53 - 69岁)。所采用的手术方法在技术上与文献中使用的方法有所不同。平均随访时间为37±11个月(范围19 - 58个月)。测量并统计比较了术前和术后特种外科医院评分系统(HSS)评分、胫骨放射学坡度、Insall - Salvati指数、Blackburne - Peel指数、Caton指数、股胫解剖轴角、股骨髁与胫骨平台之间的角度以及胫骨平台与胫骨轴之间的角度。术后HSS评分在统计学上高于术前HSS评分。股胫轴角、股骨髁与胫骨平台之间的角度以及胫骨平台与胫骨轴之间的角度显著减小。术前和术后的Insall - Salvati指数、Blackburne - Peel指数或Caton指数之间未观察到统计学差异。当我们进行胫骨近端内侧双平面后结节开放性楔形截骨术时,观察到了临床和放射学上的恢复,但髌骨高度没有改变。

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