Zhao Yun, Hu Wenjin, Huang Jingmin, Li Dongchao, Jia Litao, Zhong Congli, Zhao Xiaohu
Department of Orthopedics, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, 300120, P.R.China.
Department of Sports Injuries and Arthroscopic Branch, Tianjin Hospital, Tianjin, 300211,
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018 Feb 15;32(2):157-161. doi: 10.7507/1002-1892.201710014.
To explore the short-term effectiveness of medial open wedge high tibial osteotomy (OWHTO) combined with posterior slope angle of tibial plateau correction to treat the osteoarthritis of limited flexion knee with varus deformity.
The data of 18 cases (18 knee) with osteoarthritis of limited flexion knee with varus deformity between January 2014 and July 2016 were analyzed retrospectively. There were 6 males and 12 females with an average age of 54.9 years (range, 48-64 years). There were 8 cases of left knee and 10 cases of right knee. The varus of knee ranged from 7.45 to 15.52° (mean, 10.63°). According to Kellgren-Lawrence grading standard, there were 4 cases of grade Ⅱ and 14 of grade Ⅲ. OWHTO was used to adjust the varus deformity, and the posterior slope angle of tibial plateau was adjusted to solve the limited flexion.
The thickness of osteotomy was 10-19 mm (mean, 14.91 mm). The operation time was 1.2-2.0 hours (mean, 1.4 hours). All incisions healed by first intension. All patients were followed up 1.0-2.5 years, with an average of 1.5 years. At last follow-up, the range of knee flexion and Lysholm score, Hospital for Special Surgery (HSS) score, and International Knee Documentation Committee (IKDC) score were significantly higher than preoperative ones, showing significant differences ( <0.05). X-ray films showed that the osteotomy healed at 3- 7 months (mean, 3.6 months) after operation. At last follow-up, the limb alignment by the relative position of tibial plateau and the posterior slope angle of tibial plateau were significantly improved, showing significant differences when compared with preoperative ones ( <0.05).
The OWHTO combined with posterior slope angle of tibial plateau correction can significantly improve the range of flexion and functional score in short-term.
探讨内侧开放楔形高位胫骨截骨术（OWHTO）联合胫骨平台后倾角度矫正治疗伴有内翻畸形的膝关节屈曲受限型骨关节炎的短期疗效。
回顾性分析2014年1月至2016年7月间18例（18膝）伴有内翻畸形的膝关节屈曲受限型骨关节炎患者的资料。其中男性6例,女性12例，平均年龄54.9岁（范围48 - 64岁）。左膝8例，右膝10例。膝关节内翻角度为7.45°至15.52°（平均10.63°）。根据Kellgren-Lawrence分级标准，Ⅱ级4例，Ⅲ级14例。采用OWHTO矫正内翻畸形，并调整胫骨平台后倾角度以解决屈曲受限问题。
截骨厚度为10 - 19mm（平均14.91mm）。手术时间为1.2 - 2.0小时（平均1.4小时）。所有切口均一期愈合。所有患者均获随访1.0 - 2.5年，平均1.5年。末次随访时，膝关节屈曲范围、Lysholm评分、特种外科医院（HSS）评分及国际膝关节文献委员会（IKDC）评分均显著高于术前，差异有统计学意义（<0.05）。X线片显示术后3 - 7个月（平均3.6个月）截骨愈合。末次随访时，胫骨平台相对位置及胫骨平台后倾角度所反映的下肢力线较术前显著改善，差异有统计学意义（<0.05）。
OWHTO联合胫骨平台后倾角度矫正可在短期内显著改善膝关节屈曲范围及功能评分。
