Saragaglia Dominique, Massfelder Julie, Refaie Ramsay, Rubens-Duval Brice, Mader Roch, Rouchy René Christopher, Pailhé Régis
Department of Orthopaedic Surgery and Sport Traumatology, Grenoble South Teaching Hospital, 38130, Échirolles, France.
Department of Trauma and Orthopaedics, Wansbeck Hospital, Northumberland, UK.
Int Orthop. 2016 Jan;40(1):35-40. doi: 10.1007/s00264-015-2791-x. Epub 2015 May 7.
The aim of this study was to evaluate the medium-term results of total knee replacements (TKRs) after medial opening wedge valgising tibial osteotomy to those of primary TKR (TKR1). The hypothesis being that there would be no difference in results between these groups.
Series 1 was made up of 45 TKRs after medial opening wedge high tibial osteotomy (MHTO)-30 men and ten women at an average age of 69 ± seven years (54-82). This was compared to a second series of TKR1s-30 men and ten women at an average age of 69 ± seven years (55-78). The average IKS scores were 91 ± 22.5 points (42-129) and 86 ± 18 points (38-116) in the two groups respectively. The average pre-operative HKA angle was 179 ± 5° (169-193°) in group 1, and 173 ± 7.5° (161-193°) in group 2. Tibial mechanical axes were 90.5 ± 4° (of which 24 knees had a valgus angle) and 85.05 ± 3.5° (79-93°) in the two groups respectively.
All patients were reviewed at an average follow-up of 47 ± 24.5 months for series 1 and 185 ± 8.5 months for series 2. The average IKS score was 184 ± 6 for series 1 (172-200) and 185 ± 8.5 (163-200) for series 2 (p = 0.872). Thirty-seven patients in series 1 and 38 patients in series 2 were either extremely satisfied or satisfied with the intervention. The average post-operative HKA angle was 180.5 ± 2.5° and 181 ± 2° (p = 0.122) and the average tibial mechanical axis was 89 ± 1.5° against 90 ± 1° (p = 0.001). The results of the 24 knees with a valgus tibial mechanical axis were statistically no different.
TKRs post medial opening wedge high tibial osteotomy have identical results to primary TKRs even in knees with a valgus tibial mechanical axis.
本研究旨在评估内侧开口楔形胫骨外翻截骨术后全膝关节置换术（TKR）的中期结果，并与初次全膝关节置换术（TKR1）的结果进行比较。假设是这些组之间的结果没有差异。
第一组由45例内侧开口楔形高位胫骨截骨术（MHTO）后的TKR组成，其中30名男性和10名女性，平均年龄69±7岁（54 - 82岁）。将其与第二组TKR1进行比较，第二组有30名男性和10名女性，平均年龄69±7岁（55 - 78岁）。两组的平均IKS评分分别为91±22.5分（42 - 129分）和86±18分（38 - 116分）。第一组术前平均HKA角为179±5°（169 - 193°），第二组为173±7.5°（161 - 193°）。两组的胫骨机械轴分别为90.5±4°（其中24例膝关节有外翻角）和85.05±3.5°（79 - 93°）。
第一组患者平均随访47±24.5个月，第二组患者平均随访185±8.5个月。第一组的平均IKS评分为184±6（172 - 200），第二组为185±8.5（163 - 200）（p = 0.872）。第一组37例患者和第二组38例患者对干预措施极其满意或满意。术后平均HKA角分别为180.5±2.5°和181±2°（p = 0.122），平均胫骨机械轴分别为89±1.5°和90±1°（p = 0.001）。24例有胫骨外翻机械轴的膝关节结果在统计学上无差异。
内侧开口楔形高位胫骨截骨术后的TKR即使在有胫骨外翻机械轴的膝关节中也与初次TKR有相同的结果。
