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倒L形构型的开放性楔形外翻高位胫骨截骨术技术

Open-Wedge Valgus High Tibial Osteotomy Technique With Inverted L-Shaped Configuration.

作者信息

Monllau Juan C, Erquicia Juan I, Ibañez Federico, Ibañez Maximiliano, Gelber Pablo E, Masferrer-Pino Angel, Pelfort Xavier

机构信息

Department of Orthopaedic Surgery, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain.

ICATME, Hospital Universitari Dexeus, Universitat Autònoma de Barcelona, Barcelona, Spain.

出版信息

Arthrosc Tech. 2017 Nov 13;6(6):e2161-e2167. doi: 10.1016/j.eats.2017.08.009. eCollection 2017 Dec.

DOI:10.1016/j.eats.2017.08.009
PMID:29349013
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5765526/
Abstract

High tibial osteotomy (HTO) is a useful alternative in the treatment of symptomatic varus malalignment. However, among its drawbacks is the tendency to decrease patellar height and increase the posterior tibial slope. The increased tibial slope increases anterior cruciate ligament tension and may compromise its function. On the other hand, patella baja often causes anterior knee pain and, over time, may favor degeneration of the patellofemoral joint. The aim of this study is to describe a technical modification of the standard open-wedge HTO. It consists of a double inverted L-shaped cut, which includes the anterior tibial tuberosity in the proximal fragment, to avoid any alteration of patellar height and control the eventual increase of the posterior tibial slope.

摘要

高位胫骨截骨术（HTO）是治疗有症状的内翻畸形的一种有效替代方法。然而，其缺点之一是有降低髌骨高度和增加胫骨后倾的趋势。增加的胫骨倾斜度会增加前交叉韧带的张力，并可能损害其功能。另一方面，低位髌骨常导致膝前疼痛，随着时间的推移，可能会促进髌股关节的退变。本研究的目的是描述一种标准开放楔形HTO的技术改良。它包括一个双倒L形切口，近端骨块包括胫骨前结节，以避免髌骨高度的任何改变，并控制胫骨后倾的最终增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cd8/5765526/1ff34ec428a7/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cd8/5765526/3a5635c227c5/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cd8/5765526/fd11b6a8b5cd/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cd8/5765526/d0cce0f4d97d/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cd8/5765526/5562bceef78b/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cd8/5765526/0c4e293e1989/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cd8/5765526/8e0ea377a9df/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cd8/5765526/1ff34ec428a7/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cd8/5765526/3a5635c227c5/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cd8/5765526/fd11b6a8b5cd/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cd8/5765526/d0cce0f4d97d/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cd8/5765526/5562bceef78b/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cd8/5765526/0c4e293e1989/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cd8/5765526/8e0ea377a9df/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cd8/5765526/1ff34ec428a7/gr7.jpg

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本文引用的文献

1
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Knee Surg Sports Traumatol Arthrosc. 2017 Jan;25(1):314-318. doi: 10.1007/s00167-015-3571-2. Epub 2015 Mar 13.
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Patellar height modification after high tibial osteotomy by either medial opening-wedge or lateral closing-wedge osteotomies.胫骨高位截骨术行内侧撑开楔形截骨或外侧闭合楔形截骨后髌骨关节面高度的变化。
Knee Surg Sports Traumatol Arthrosc. 2013 Jan;21(1):255-9. doi: 10.1007/s00167-012-2304-z. Epub 2012 Nov 25.
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混合高位胫骨截骨术优于内侧开放高位胫骨截骨术治疗伴髌股关节炎的内翻膝。
Knee Surg Sports Traumatol Arthrosc. 2019 Apr;27(4):1332-1338. doi: 10.1007/s00167-018-5015-2. Epub 2018 Jun 8.
Different changes in slope between the medial and lateral tibial plateau after open-wedge high tibial osteotomy.
胫骨高位截骨术后胫骨内侧和外侧平台的斜率变化不同。
Knee Surg Sports Traumatol Arthrosc. 2013 Jan;21(1):32-8. doi: 10.1007/s00167-012-2229-6. Epub 2012 Oct 4.
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Increase in posterior tibial slope would result in correction loss in frontal plane after medial open-wedge high tibial osteotomy.胫骨后倾角的增加会导致内侧开放楔形胫骨高位截骨术后冠状面的矫正丢失。
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