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[股骨外侧开口变向截骨术治疗与特发性膝外翻相关的外侧股胫关节骨关节炎:10例回顾性研究]

[Femoral varising osteotomy by external opening for the treatment of lateral femorotibial gonarthroses associated with idiopathic genu valgum: a retrospective a study of 10 cases].

作者信息

Cheikh Asma Ben, Maitigue Mahmoud Ben, Masmoudi Karim, Mouelhi Thabet, Naouar Nader, Grissa Yamen, Bouattour Karim, Osman Walid, Ben Ayeche Mohamed Laziz

机构信息

Service d'Hygiène Hospitalière, CHU Farhat Hached de Sousse, Faculté de Médecine de Sousse, CP 4000, Sousse, Tunisie.

Service de Chirurgie Orthopédique et Traumatologique, Faculté de Médecine de Sousse, CHU Sahloul, Hammam Sousse CP 4011, Sousse, Tunisie.

出版信息

Pan Afr Med J. 2017 Sep 13;28:22. doi: 10.11604/pamj.2017.28.22.12014. eCollection 2017.

Abstract

Femoral varus osteotomy is a conservative treatment for external single-compartment gonarthrosis. This surgical procedure is little used and outcomes are little studied.This study aimed to assess the clinical and radiological results of femoral varising osteotomy in subjects with external femorotibial gonarthrosis associated with idiopathic genu valgum whose data were recorded over a period of 21 years (1992- 2013) in the Department of Orthopedics at Sahloul University Hospital, Sousse. The clinical evaluation of patients was performed using the IKS score (International Knee Society). Radiological assessment was based on pre-operative work-up and final follow-up assessment. We here report a case series of 9 patients (and 10 knees) whose average age was 45.2 years, with a sex ratio of 0.5. Mean follow-up was 99-months. Average knee score ranged from 48.4 points preoperatively to 73.5 points at the final follow-up assessment, with a statistically significant improvement (p<10-3). Medium functional score significantly improved, with a preoperative value of 49.5 points and a value of 72 points at the final follow-up assessment. Final correction helped to reduce valgus condition with an average of 3.7° and a preoperative value of 14°. This study, as well as the analysis of literature, indicates that femoral varising osteotomy is the treatment of choice for invalidating genu valgum of femoral origin, without any rheumatoid arthritis, overweight, internal femorotibial nor severe femoropatellar arthritis.

摘要

股骨内翻截骨术是治疗外侧单髁膝关节病的一种保守疗法。该手术方法很少使用,其疗效也鲜少被研究。本研究旨在评估在苏塞萨赫勒大学医院骨科,对伴有特发性膝外翻的外侧股胫关节病患者进行股骨内翻截骨术的临床和放射学结果,这些患者的数据记录于1992年至2013年的21年间。采用国际膝关节协会(IKS)评分对患者进行临床评估。放射学评估基于术前检查和最终随访评估。我们在此报告一组9例患者(10个膝关节)的病例系列,患者平均年龄为45.2岁,性别比为0.5。平均随访时间为99个月。膝关节平均评分从术前的48.4分提高到最终随访评估时的73.5分,差异具有统计学意义(p<10-3)。功能评分中等程度显著改善,术前评分为49.5分,最终随访评估时为72分。最终矫正使外翻情况平均减少3.7°,术前外翻角度为14°。本研究以及文献分析表明,股骨内翻截骨术是治疗无类风湿关节炎、超重、内侧股胫关节病或严重髌股关节炎的原发性股骨膝外翻的首选治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d35/5681007/e3d8f1a5c31e/PAMJ-28-22-g001.jpg

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