Kim Jun-Ho, Kim Hyun-Jung, Lee Dae-Hee
Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Preventive medicine, Korea University College of Medicine, Seoul, Korea.
PLoS One. 2017 Jul 13;12(7):e0181328. doi: 10.1371/journal.pone.0181328. eCollection 2017.
Theoretical considerations suggest that leg length increases after opening wedge high tibial osteotomy (HTO) and decreases after closing wedge HTO; however, in vivo studies have yielded conflicting results. This meta-analysis therefore assessed changes in leg length after opening wedge and closing wedge HTO.
All studies comparing pre- and postoperative leg length in patients who underwent opening and/or closing wedge HTO were included. Two reviewers independently recorded data from each study in terms of sample size as well as preoperative and postoperative leg length of open wedge and/or closed wedge HTO groups.
Four studies were included in the meta-analysis. Although pooled results showed leg length changes from before to after surgery were -6.93 mm (95% confidence interval [CI]: -17.53 to 3.67 mm; P = 0.20) in opening wedge HTO and 1.97 mm (95% CI: -7.13 to 11.07 mm; P = 0.67) in closing wedge HTO, respectively, these values were statistically not significant. However, the difference in the pooled mean leg length change from before to after surgery between opening wedge and closing wedge HTO was 8 mm, a difference that was significant (95% CI: 6.53 to 9.46 mm; P<0.001).
The change in leg length was not statistically significant for either opening or closing wedge HTO. However, leg length change from before to after surgery was 8 mm greater for opening wedge HTO than for closing wedge HTO.
理论推测表明，开放楔形高位胫骨截骨术（HTO）后腿长增加，闭合楔形HTO后腿长缩短；然而，体内研究结果却相互矛盾。因此，本荟萃分析评估了开放楔形和闭合楔形HTO术后腿长的变化。
纳入所有比较接受开放和/或闭合楔形HTO患者术前和术后腿长的研究。两名评价者独立记录每项研究的样本量以及开放楔形和/或闭合楔形HTO组术前和术后的腿长数据。
荟萃分析纳入了四项研究。尽管汇总结果显示，开放楔形HTO术后腿长变化为-6.93 mm（95%置信区间[CI]：-17.53至3.67 mm；P = 0.20），闭合楔形HTO术后腿长变化为1.97 mm（95% CI：-7.13至11.07 mm；P = 0.67），但这些数值在统计学上均无显著意义。然而，开放楔形HTO与闭合楔形HTO术后腿长变化的合并均值差异为8 mm，该差异具有统计学意义（95% CI：6.53至9.46 mm；P<0.001）。
开放或闭合楔形HTO术后腿长变化在统计学上均无显著意义。然而，开放楔形HTO术后腿长变化比闭合楔形HTO术后腿长变化大8 mm。
