Schwartz Claude
Clinique des 3 frontières, 68300, Saint-Louis, France.
Eur J Orthop Surg Traumatol. 2018 Jul;28(5):799-809. doi: 10.1007/s00590-017-2109-3. Epub 2018 Jan 10.
Medial knee osteoarthritis on angular varus deformity of a lower limb is very common. Open-wedge high tibial osteotomy is a treatment of choice if cartilage is not excessively worn (Allback 1 or 2). The technique based on a plate fixation and the bone defect filled with calcium phosphate cement is thoroughly described. Data at 1, 3, 6 months and 1 year of a 19 cases continuous and prospective series are collected and analysed. Mean age at the time of operation was 55 years. The average preoperative varus deformity was 5° and corrected to an average postoperative valgus of 4° (range 3°-6°). Each control includes the collection of eventual complications, the measurement of health status (quality of life and functional scores) and antero-posterior and lateral X-rays. All osteotomies were considered healed at 6 weeks without any correction loss except one, probably result of a technical error. There was no difference in clinical and functional results between the group and the literature, but the final result occurred earlier in the treatment when the bone defect was filled with either calcium phosphate cement. Faster recovery involved no specific complication and enabled outpatient treatment in a majority of patients.
下肢内翻畸形所致的膝关节内侧骨关节炎非常常见。如果软骨磨损不过度（奥尔贝克1级或2级），开放楔形高位胫骨截骨术是一种首选治疗方法。文中详细描述了基于钢板固定和用磷酸钙骨水泥填充骨缺损的技术。收集并分析了一个19例连续前瞻性系列病例在1个月、3个月、6个月和1年时的数据。手术时的平均年龄为55岁。术前平均内翻畸形为5°，术后平均矫正为外翻4°（范围为3°-6°）。每次复查包括收集可能出现的并发症、评估健康状况（生活质量和功能评分）以及拍摄前后位和侧位X线片。所有截骨术在6周时均被认为愈合，除了1例可能因技术失误外，没有出现任何矫正丢失情况。该组病例的临床和功能结果与文献报道无差异，但当骨缺损用磷酸钙骨水泥填充时，治疗的最终结果出现得更早。更快的恢复过程未出现特定并发症，并且大多数患者能够接受门诊治疗。
