Feucht M J, Mehl J, Forkel P, Imhoff A B, Hinterwimmer S
Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Freiburg, Hugstetter Straße 55, 79106, Freiburg, Deutschland.
Abteilung und Poliklinik für Sportorthopädie, Klinikum rechts der Isar, München, Deutschland.
Oper Orthop Traumatol. 2017 Aug;29(4):320-329. doi: 10.1007/s00064-017-0503-y. Epub 2017 Jun 2.
To shift the weight-bearing axis of the lower limb medially by opening a lateral-based metaphyseal osteotomy at the distal femur.
Femoral-based valgus malalignment and symptomatic lateral unicompartimental osteoarthritis, lateral hyperpression syndrome, cartilage therapy of the lateral compartment, lateral meniscal replacement/transplantation, medial instability with valgus thrust, reconstruction of the medial collateral ligament, patellar instability and/or maltracking.
Advanced cartilage damage (>grade 2) or subtotal meniscal loss of the medial compartment, age >65 years (relative), nicotine abuse, body mass index >30, flexion contracture >25°, corrections with a wedge base >10 mm in case of congenital deformities, inflammatory or septic arthritis, severe osteoporosis.
Lateral approach to the distal femur; biplanar osteotomy (frontal + axial osteotomy), gradual opening of the osteotomy, osteotomy fixation with a locking plate.
Free range of motion. Partial weight bearing with 20 kg for 2 weeks, followed by progressive weight bearing thereafter.
Mean improvement of knee scores from 20-30 points and mean 10-year survival rate of 80% in patients with lateral unicompartimental osteoarthritis. Mean complication rate of 9%.
通过在股骨远端进行基于外侧的干骺端截骨术，使下肢负重轴向内移位。
基于股骨的外翻畸形和有症状的外侧单髁骨关节炎、外侧高压综合征、外侧间室软骨治疗、外侧半月板置换/移植、伴有外翻推力的内侧不稳定、内侧副韧带重建、髌骨不稳定和/或轨迹不良。
内侧间室严重软骨损伤（>2级）或半月板大部分缺失、年龄>65岁（相对禁忌）、尼古丁滥用、体重指数>30、屈曲挛缩>25°、先天性畸形时楔形基底矫正>10mm、炎性或化脓性关节炎、严重骨质疏松症。
股骨远端外侧入路；双平面截骨（额状面+轴位截骨），逐渐打开截骨处，用锁定钢板固定截骨。
自由活动范围。部分负重20kg，持续2周，之后逐渐增加负重。
外侧单髁骨关节炎患者膝关节评分平均提高20 - 30分，平均10年生存率为80%。平均并发症发生率为9%。
