González-Solís Joan Manuel Burdeus, Díez-Santacoloma Iván, Llorens Albert Isidro
Hospital Universitario Sagrat Cor, Barcelona, Spain.
Eur J Orthop Surg Traumatol. 2017 Jul;27(5):705-709. doi: 10.1007/s00590-016-1870-z. Epub 2016 Oct 21.
Anterior tibial tubercle (ATT) osteotomy facilitates exposure in knee arthroplasty. However, it is not without complications. We have introduced some technical modifications that reduce the surgical aggression by designing a short osteotomy that does not invade the intramedullary canal, and synthesizing it with three cerclage wires with a particular layout that increases the solidity of the system. A retrospective review was performed on the surgical revision of total knee replacement cases intervened in our center that required an ATT osteotomy from February 2014 to February 2015, and who had a minimum clinical follow-up of 12 months. In all cases, there was an average proximal increase in ATT of 5 mm and, however, did not result in any loss of knee extension. All the osteotomies achieved complete bone consolidation at 3 months. There were no other complications. Our technique may be a valid option as it shows satisfactory results and demonstrates that a small increase in ATT does not affect the final clinical outcome.
胫骨结节前路截骨术有助于膝关节置换术中的暴露。然而，它并非没有并发症。我们引入了一些技术改进，通过设计不侵入髓内管的短截骨术来减少手术创伤，并使用三根具有特定布局的环扎钢丝将其合成，从而增加系统的稳固性。对2014年2月至2015年2月在我们中心接受干预且需要进行胫骨结节前路截骨术的全膝关节置换病例的手术翻修进行了回顾性研究，这些病例的临床随访时间至少为12个月。在所有病例中，胫骨结节近端平均增加了5毫米，然而，并未导致膝关节伸展功能丧失。所有截骨术在3个月时均实现了完全骨愈合。没有其他并发症。我们的技术可能是一种有效的选择，因为它显示出令人满意的结果，并表明胫骨结节的小幅增加不会影响最终的临床结果。
