Kim Min Kyu, Ha Jeong Ku, Lee Dhong Won, Nam Sang Wook, Kim Jin Goo, Lee Yong Seuk
Department of Orthopedic Surgery, Seoul Paik Hospital, Inje University, 85, Jeo-dong 2-ga, Jung-gu, Seoul, Korea.
Knee Surg Sports Traumatol Arthrosc. 2015 Jul;23(7):1999-2006. doi: 10.1007/s00167-014-2842-7. Epub 2014 Jan 30.
The aim of this study was to compare the clinical and radiological results of the wedge plate and locking plate systems in open-wedge high tibial osteotomy.
Between 2007 and 2010, the wedge plate was used as the fixation device for osteotomy to treat a total of 67 patients; from 2009 to 2010, the locking plate was used in 19 patients. Matching for gender, age, body mass index (BMI), and articular cartilage status, 19 pairs of wedge plate and locking plate cases were enrolled in a 1:1 retrospective matched-pair analysis. Clinical data were collected and scored using the visual analogue scale and the International Knee Documentation subjective score. Additionally, pre-operative, immediate post-operative, and last follow-up radiographs were obtained to assess changes in the hip-knee-ankle (H-K-A) angle and posterior tibial slope.
No significant differences in gender, age, BMI, follow-up period, and articular cartilage status were found between the groups. Although the initial correction of the H-K-A angles, 8.9° ± 1.9° and 9.4° ± 4.2° for the wedge plate and locking plate groups, respectively, was not significantly different, a significant difference (P = 0.046) in the final correction angles, 7.2° ± 2.1° and 9.4° ± 4.4°, respectively, was found. The increase in the posterior tibial slope, 0.5° ± 2.0° and 3.2° ± 2.6°, for the wedge plate and locking plate groups, respectively, was significantly different (P = 0.010). When classified according to the correction angle, we found that when the initial correction angle exceeded 10.0°, an average correction loss of 2.9° ± 0.5° was observed in the wedge plate group, whereas an average increase in the posterior tibial slope of 5.8° ± 1.6° was evident for the locking plate group.
At 2 years post-operatively, the final correction angles of the wedge and the locking plate groups differed significantly, and the wedge plate group had a smaller increase in the posterior tibial slope than the locking plate group.
Retrospective comparative study, Level III.
本研究旨在比较楔形钢板和锁定钢板系统在开放性高位胫骨截骨术中的临床和影像学结果。
2007年至2010年期间，楔形钢板被用作截骨术的固定装置，共治疗67例患者；2009年至2010年期间，19例患者使用了锁定钢板。根据性别、年龄、体重指数（BMI）和关节软骨状况进行匹配，19对楔形钢板和锁定钢板病例纳入1:1回顾性配对分析。收集临床数据，并使用视觉模拟量表和国际膝关节文献主观评分进行评分。此外，获取术前、术后即刻和末次随访的X线片，以评估髋-膝-踝（H-K-A）角和胫骨后倾角的变化。
两组在性别、年龄、BMI、随访时间和关节软骨状况方面无显著差异。虽然楔形钢板组和锁定钢板组的初始H-K-A角矫正分别为8.9°±1.9°和9.4°±4.2°，差异无统计学意义，但最终矫正角分别为7.2°±2.1°和9.4°±4.4°，差异有统计学意义（P = 0.046）。楔形钢板组和锁定钢板组的胫骨后倾角增加分别为0.5°±2.0°和3.2°±2.6°，差异有统计学意义（P = 0.010）。根据矫正角度分类时，我们发现当初始矫正角度超过10.0°时，楔形钢板组平均矫正丢失2.9°±0.5°，而锁定钢板组胫骨后倾角平均增加5.8°±1.6°。
术后2年，楔形钢板组和锁定钢板组的最终矫正角度有显著差异，且楔形钢板组胫骨后倾角的增加小于锁定钢板组。
回顾性比较研究，III级。
