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60 岁以下患者行胫骨高位截骨术后重返运动和生活质量。

Return to sports and quality of life after high tibial osteotomy in patients under 60 years of age.

机构信息

Département de chirurgie orthopédique et traumatologie, université Paris-Est Créteil, groupe hospitalier Henri-Mondor, Assistance publique-hôpitaux de Paris (AP-HP), 94010 Créteil, France.

Département de chirurgie orthopédique et traumatologie, université Paris-Est Créteil, groupe hospitalier Henri-Mondor, Assistance publique-hôpitaux de Paris (AP-HP), 94010 Créteil, France; Service de chirurgie orthopédique et traumatologie du sport, clinique Saint-Privat, 34760 Boujan-sur-Libron, France.

出版信息

Orthop Traumatol Surg Res. 2017 Dec;103(8):1189-1191. doi: 10.1016/j.otsr.2017.08.013. Epub 2017 Sep 28.

Abstract

INTRODUCTION

Since knee osteoarthritis is unicompartmental in most cases, a knee osteotomy is the most logical solution to limit degeneration of the arthritic compartment, thereby delaying knee arthroplasty. Younger patients have high functional demands. The purpose of this study was to evaluate the return to sports and quality of life after high tibial osteotomy (HTO) in athletic patients less than 60 years of age. The hypothesis was that patients can return to sports within 1 year of HTO.

MATERIALS AND METHODS

A single-centre, retrospective study was performed of 30 patients under 60 years of age with medial tibiofemoral osteoarthritis and no history of surgery or trauma who underwent HTO between January 2014 and August 2015. The primary endpoint was the return to sport at 1 year based on the Tegner score. Secondary endpoints were the subjective IKDC score, Lysholm score and SF-36.

RESULTS

The mean follow-up was 1.3 years [1-1.5] and no patients were lost to follow-up. All the patients had returned to sports at 1 year: 73.3% at their pre-surgery level (before the pain started) and 23.3% at a higher level. Their quality of life was significantly improved according to the SF-36 questionnaire: 65.3% pre-operatively compared with 72.5% postoperatively (P=0.01). The preoperative and 1-year postoperative scores were comparable for the Tegner (P=0.167), IKDC (P=0.093) and Lysholm (P=0.061).

CONCLUSION

HTO allows patients to resume their sports activities within 1 year of surgery and significantly improves their quality of life.

LEVEL OF EVIDENCE

Level IV - Retrospective cohort study.

摘要

简介

由于膝关节骨关节炎在大多数情况下为单室性,因此截骨术是限制关节炎部位退化从而延迟膝关节置换的最合理方法。年轻患者的功能需求较高。本研究的目的是评估小于 60 岁的运动患者行胫骨高位截骨术(HTO)后的重返运动和生活质量。假设是患者可以在 HTO 后 1 年内重返运动。

材料与方法

这是一项单中心、回顾性研究,纳入了 2014 年 1 月至 2015 年 8 月期间行 HTO 的 30 例年龄小于 60 岁且有内侧胫股关节炎病史但无手术或外伤史的患者。主要终点是根据 Tegner 评分在 1 年内重返运动。次要终点是主观 IKDC 评分、Lysholm 评分和 SF-36。

结果

平均随访时间为 1.3 年[1-1.5],无患者失访。所有患者在 1 年内都重返运动:73.3%恢复到术前水平(疼痛开始前),23.3%恢复到更高水平。他们的生活质量根据 SF-36 问卷明显改善:术前为 65.3%,术后为 72.5%(P=0.01)。Tegner(P=0.167)、IKDC(P=0.093)和 Lysholm(P=0.061)评分在术前和 1 年时无显著差异。

结论

HTO 可使患者在术后 1 年内恢复运动活动,并显著提高生活质量。

证据等级

IV 级-回顾性队列研究。

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