Department of Orthopedic Surgery, Murup Hospital, Gyeongnam, South Korea.
Arthroscopy. 2013 Jun;29(6):1063-71. doi: 10.1016/j.arthro.2013.02.020. Epub 2013 Apr 26.
The purpose of this study was to perform a retrospective clinical and radiographic evaluation after opening-wedge high tibial osteotomy (HTO) using a short spacer plate (Aescula; B. Braun Korea, Seoul, South Korea) and rigid long plate (TomoFix plate; Mathys, Bettlach, Switzerland) at follow-up 2 years postoperatively.
We performed 94 opening-wedge HTOs with the Aescula plate (group I) and 92 HTOs with the TomoFix plate (group II). Patients underwent clinical and radiographic evaluations preoperatively and at 2 years postoperatively. Clinical evaluations were performed with Knee Society scores. Radiographic analysis included the mechanical tibiofemoral angle (mTFA) and the slope of the tibia angle with preoperative and postoperative full weight-bearing anteroposterior whole-leg views, as well as anteroposterior, lateral, and Merchant views of the knee. We measured the mTFA. In addition, we evaluated the complications in each group. The follow-up period was 2 years.
At follow-up 2 years postoperatively, we observed an overall complication rate of 38% in group I and 26% in group II (P = .083). We found plate-related complication rates of 20% in group I and 9% in group II (P = .039). Plate-related complications included loss of correction, fracture of the tibial plateau, screw failure, malunion, and fracture of the lateral cortical bone. The mean mTFA was -6.0° ± 3.2° in group I and -4.6° ± 2.8° in group II preoperatively (P = .262). The mean mTFA was 1.0° ± 3.1° in group I and 1.5° ± 2.3° in group II at the latest follow-up (P = .034). In group I, the mean Knee Society knee score and function score were 60.0 ± 12.9 and 57.9 ± 26.8, respectively, preoperatively. They improved to 92.1 ± 8.1 and 89.0 ± 15.1, respectively, at follow-up (P = .001 and P = .001, respectively). In group II, the mean Knee Society knee score and function score were 57.5 ± 14.8 and 57.4 ± 22.1, respectively, preoperatively. They improved to 95.5 ± 5.4 and 95.0 ± 7.6, respectively, at follow-up (P = .001 and P = .001, respectively). In addition, the mean postoperative knee score and function score in group II were higher than those in group I (P = .001 and P = .001, respectively).
We have shown a high plate-related complication rate and a significant loss of correction during a short-term follow-up period (2 years) after opening-wedge HTO using the new short spacer HTO plate compared with the rigid long plate.
Level IV, therapeutic case series.
本研究旨在对使用短间隔支撑钢板（Aescula；韩国 B. Braun 公司，韩国首尔）和刚性长钢板（TomoFix 钢板；Mathys，Bettlach，瑞士）进行外侧开放楔形胫骨高位截骨术（HTO）后 2 年进行回顾性临床和影像学评估。
我们对 94 例使用 Aescula 钢板（I 组）和 92 例使用 TomoFix 钢板（II 组）进行外侧开放楔形 HTO 的患者进行了临床和影像学评估。患者在术前和术后 2 年进行了临床和影像学评估。临床评估采用膝关节学会评分（Knee Society scores）进行。影像学分析包括机械性胫股角（mTFA）和胫骨角斜率，使用术前和术后负重全长正位、侧位和 Merchant 位 X 线片进行评估。我们测量了 mTFA。此外，我们评估了每组的并发症。随访时间为 2 年。
术后 2 年随访时，I 组总体并发症发生率为 38%，II 组为 26%（P =.083）。我们发现 I 组钢板相关并发症发生率为 20%，II 组为 9%（P =.039）。钢板相关并发症包括矫正丢失、胫骨平台骨折、螺钉失效、畸形愈合和外侧皮质骨骨折。I 组术前 mTFA 平均为-6.0°±3.2°，II 组为-4.6°±2.8°（P =.262）。I 组末次随访时 mTFA 平均为 1.0°±3.1°，II 组为 1.5°±2.3°（P =.034）。I 组术前膝关节学会膝关节评分和功能评分分别为 60.0±12.9 和 57.9±26.8，术后分别改善至 92.1±8.1 和 89.0±15.1（P =.001 和 P =.001）。II 组术前膝关节学会膝关节评分和功能评分分别为 57.5±14.8 和 57.4±22.1，术后分别改善至 95.5±5.4 和 95.0±7.6（P =.001 和 P =.001）。此外，II 组术后膝关节评分和功能评分均高于 I 组（P =.001 和 P =.001）。
与刚性长钢板相比，新型短间隔支撑 HTO 钢板在外侧开放楔形 HTO 术后 2 年（短期随访）期间显示出较高的钢板相关并发症发生率和显著的矫正丢失。
IV 级，治疗性病例系列研究。
