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在全膝关节置换术中使用胫骨近端截骨自体骨移植治疗重度膝内翻畸形;与对照组的结果比较。

Using Tibia Proximal Cut Autograft in Advanced Varus Knee Deformity in Total Knee Arthroplasty; Outcomes Compared to the Control Group.

作者信息

Arslan Aydin

机构信息

Elit Istanbul Medical Center, Orthopaedics and Traumatology, Istanbul Gelisim university, Istanbul, Turkey.

出版信息

Open Orthop J. 2018 Oct 24;12:405-410. doi: 10.2174/1874325001812010405. eCollection 2018.

Abstract

BACKGROUND

The purpose of this study was to compare the outcomes of Total Knee Arthroplasty (TKA) performed for advanced varus knee deformity, which is performed by using tibia proximal cut bone for the reconstruction of the tibia proximal medial bone defects, with a control group consisting of TKAs which did not need reconstruction.

METHODS

Patients in the present study underwent total knee arthroplasty between 2009 and 2015. 12 patients with advanced varus deformity who had undergone reconstruction with tibia proximal cut autograft and 15 patients who were randomly selected from patients who did not need reconstruction, were compared clinically and radiographically.

RESULTS

The mean follow-up period of the patients was found to be 73.1 ± 19.7 (36-108) months in the reconstruction group and 73.2 ± 12.3 (39-107) months in the control group. (> 0.05) In both groups, significant improvement was observed postoperatively. In both groups, there was no evidence of loosening the required revision. WOMAC score was 32.4 ± 13.3 (8-64) in the reconstruction group and 28.9 ± 17.2 (6-70) in the control group at the last control visit. There was no difference between the groups when comparing the WOMAC scores at the last control visit. In the reconstruction group, the Hip-Knee-Ankle (HKA) angle was 26.1 ± 4.9 ° varus preoperatively and 1.3 ± 2.3 ° valgus postoperatively; and in the control group 10.1 ± 2.1 ° varus preoperatively and 2.7 ± 3.4 ° valgus postoperatively. (> 0.05).

CONCLUSION

In the present study, clinical and radiographic results of total knee arthroplasty patients, who suffered from advanced knee varus deformity and whose proximal tibia medial defects were reconstructed by using tibial proximal cut autograft, have been found to be successful when compared to the control group.

摘要

背景

本研究的目的是比较采用胫骨近端截骨重建胫骨近端内侧骨缺损的晚期膝内翻畸形全膝关节置换术(TKA)的结果与由无需重建的TKA组成的对照组的结果。

方法

本研究中的患者在2009年至2015年间接受了全膝关节置换术。对12例采用胫骨近端自体骨移植进行重建的晚期内翻畸形患者和15例从无需重建的患者中随机选取的患者进行了临床和影像学比较。

结果

重建组患者的平均随访期为73.1±19.7(36 - 108)个月,对照组为73.2±12.3(39 - 107)个月。(>0.05)两组术后均观察到显著改善。两组均无需要翻修的松动迹象。末次随访时,重建组WOMAC评分为32.4±13.3(8 - 64),对照组为28.9±17.2(6 - 70)。比较末次随访时的WOMAC评分,两组之间无差异。重建组术前髋 - 膝 - 踝(HKA)角为内翻26.1±4.9°,术后为外翻1.3±2.3°;对照组术前内翻10.1±2.1°,术后外翻2.7±3.4°。(>0.05)。

结论

在本研究中,与对照组相比,采用胫骨近端自体骨移植重建近端胫骨内侧缺损的晚期膝内翻畸形全膝关节置换术患者的临床和影像学结果是成功的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/109f/6210525/e69ebcd51b3d/TOORTHJ-12-405_F1.jpg

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