Primeau Codie A, Birmingham Trevor B, Leitch Kristyn M, Appleton C Thomas, Giffin J Robert
Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, 3M Centre, Room 1220, London, Ontario N6A 3K7, Canada; Bone and Joint Institute, University of Western Ontario, London Health Sciences Centre, University Hospital B6-200, London, Ontario N6A 5B5, Canada; School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, 1201 Western Road, London, Ontario N6G 1H1, Canada.
Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, 3M Centre, Room 1220, London, Ontario N6A 3K7, Canada; Bone and Joint Institute, University of Western Ontario, London Health Sciences Centre, University Hospital B6-200, London, Ontario N6A 5B5, Canada.
Clin Sports Med. 2019 Jul;38(3):471-482. doi: 10.1016/j.csm.2019.02.010.
Degenerative medial meniscal tears (DMMTs) are a common feature of early knee osteoarthritis (OA). Varus alignment is a strong risk factor for medial compartment knee OA and its progression. We propose that high tibial osteotomy (HTO) should be considered much earlier in the treatment algorithm for patients presenting with recurring medial knee pain, varus alignment, and DMMT, absent of radiographic OA. We provide rationale for investigating HTO as a disease-modifying intervention for secondary prevention in knee OA, and present case examples as low-level proof of principle. Finally, caveats and challenges are discussed along with proposed future research.
退行性内侧半月板撕裂（DMMT）是早期膝关节骨关节炎（OA）的常见特征。膝内翻是内侧间室膝关节OA及其进展的一个重要危险因素。我们建议，对于出现复发性膝关节内侧疼痛、膝内翻和DMMT且无影像学OA的患者，在治疗方案中应更早地考虑高位胫骨截骨术（HTO）。我们为研究HTO作为膝关节OA二级预防的疾病改善干预措施提供了理论依据，并给出病例实例作为低水平的原理证明。最后，讨论了注意事项和挑战以及未来拟开展的研究。
