Moghtadaei Mehdi, Yeganeh Ali, Boddouhi Bahram, Alaee Atefe, Farahini Hossein, Otoukesh Babak
Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran.
Department of Information Sciences, Tehran University of Medical Sciences, Tehran, Iran.
Interv Med Appl Sci. 2017 Jun;9(2):94-99. doi: 10.1556/1646.9.2017.2.20.
The aim of this study is to evaluate the effect of proximal tibia osteotomy on hip biomechanics.
This cohort study was conducted on 50 knees of 37 patients divided into two groups of unilateral and bilateral surgeries during 2015-2016. Patients underwent medial open-wedge osteotomy of proximal tibia. Axial alignment of lower limb radiography was carried out for the patients before and after the osteotomy.
Findings from unilateral and bilateral high tibial osteotomies demonstrated that the average of greater trochanter (GT) angle from femoral head center and also the average angle of knee varus were significantly decreased ( = 0.001). Although not statistically significant, the average angle of the mechanical axis of lower limb showed an increase in unilateral osteotomy ( = 0.889) and a decrease in bilateral osteotomy ( = 0.887). The average angle of pelvic obliquity after unilateral osteotomy increased significantly ( = 0.001) but showed no statistically significant difference in bilateral osteotomy ( = 0.631).
High tibial osteotomy significantly affects the GT and causes the downward replacement of GT and consequent shortening of the abductors moment arm, increased hip joint reaction force, and reduction of the shear force on the femoral neck.
本研究旨在评估胫骨近端截骨术对髋关节生物力学的影响。
本队列研究对2015年至2016年间37例患者的50个膝关节进行，分为单侧手术组和双侧手术组。患者接受胫骨近端内侧开放性楔形截骨术。在截骨术前和术后对患者进行下肢X线摄影的轴向对线检查。
单侧和双侧高位胫骨截骨术的结果表明，股骨头中心至大转子（GT）的平均角度以及膝关节内翻的平均角度均显著降低（P = 0.001）。虽然无统计学意义，但下肢机械轴的平均角度在单侧截骨术中有所增加（P = 0.889），在双侧截骨术中有所降低（P = 0.887）。单侧截骨术后骨盆倾斜的平均角度显著增加（P = 0.001），但在双侧截骨术中无统计学意义（P = 0.631）。
高位胫骨截骨术显著影响大转子，导致大转子向下移位，进而使外展肌力矩臂缩短，髋关节反应力增加，股骨颈剪切力降低。
