Amendola A, Rorabeck C H, Bourne R B, Apyan P M
Division of Orthopaedic Surgery, University Hospital, London, Ontario, Canada.
J Arthroplasty. 1989;4 Suppl:S11-7. doi: 10.1016/s0883-5403(89)80002-6.
The authors assessed the effect of proximal tibial osteotomy on the results of a subsequent total knee arthroplasty. A retrospective, clinical and radiographic analysis was carried out between a study group of 39 patients with 42 total knee arthroplasties following osteotomy and a control group of 39 patients with 41 primary arthroplasties. Outcome was assessed using the Hospital for Special Surgery (HSS) knee score, pain, function, range of motion, and radiographic evaluation. The follow-up period averaged 37 months (range, 24-50 months). The study group had 88% good or excellent results using the HSS score, compared to 90% in the control group. Function and pain improved equally in both groups. The control group had, on average, 14 degrees greater range of motion (115 degrees v. 101 degrees) after arthroplasty. The control group had, on average, posterior inclination of the tibial plateau of 7 degrees before operation and 3 degrees after operation; the corresponding values in the study group were 2 degrees and 1 degree. Using the HSS score and pain and function as parameters, previous osteotomy does not seem to affect the outcome of total knee arthroplasty. Conversely, range of motion following arthroplasty appears to be less in those with prior osteotomy. In addition, a high tibial osteotomy may alter the inclination of the tibial plateau.
作者评估了胫骨近端截骨术对随后全膝关节置换术结果的影响。对一个研究组（39例患者，共42例截骨术后进行全膝关节置换术）和一个对照组（39例患者，共41例初次置换术）进行了回顾性临床和影像学分析。使用特殊外科医院（HSS）膝关节评分、疼痛、功能、活动范围和影像学评估来评估结果。随访期平均为37个月（范围24 - 50个月）。研究组使用HSS评分的优良率为88%，而对照组为90%。两组的功能和疼痛改善程度相同。置换术后，对照组的平均活动范围比研究组大14度（115度对101度）。对照组术前胫骨平台平均后倾角为7度，术后为 3度；研究组相应的值分别为2度和1度。以HSS评分、疼痛和功能作为参数，既往截骨术似乎不影响全膝关节置换术的结果。相反，既往有截骨术的患者置换术后的活动范围似乎较小。此外，高位胫骨截骨术可能会改变胫骨平台的倾斜度。
