Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8520, Japan.
Institute of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
BMC Musculoskelet Disord. 2019 Sep 4;20(1):409. doi: 10.1186/s12891-019-2764-0.
The purpose of this study was to compare radiological features between high tibial osteotomy (HTO) and tibial condylar valgus osteotomy (TCVO), in order to define the radiological indication criteria for TCVO.
Thirty-two cases involving 35 knees that had undergone HTO and the same number that had undergone TCVO for knee osteoarthritis were retrospectively evaluated. Characteristics of both groups did not differ significantly. Lower limb alignment, bone morphology, joint congruity, and joint instability were measured in standing full-length leg and knee radiographs obtained before and after surgery.
Radiological features in the TCVO group included greater frequencies of advanced knee OA grade, varus lower limb malalignment, depression of the medial tibial plateau, and varus-valgus joint instability compared to the HTO group before surgery. However, tibial morphology, alignment of the lower limb, and joint instability improved to comparable levels after surgery in both groups.
TCVO appears preferable in cases with advanced knee OA, destroyed or inclined medial tibial plateau, widened and subluxated lateral joint, and high varus-valgus joint instability.
本研究旨在比较胫骨高位截骨术（HTO）和胫骨髁间外翻截骨术（TCVO）的影像学特征，以确定 TCVO 的影像学适应证标准。
回顾性分析了 35 例膝关节骨关节炎患者的 32 例接受 HTO 和相同数量接受 TCVO 的病例。两组的特征无显著差异。在手术前后的站立全长下肢和膝关节正位片上测量下肢对线、骨形态、关节吻合度和关节不稳定。
TCVO 组术前影像学特征包括更常见的膝关节 OA 晚期分级、下肢内翻对线不良、内侧胫骨平台凹陷和内外翻关节不稳定，高于 HTO 组。然而，两组术后胫骨形态、下肢对线和关节不稳定均改善至相似水平。
TCVO 似乎更适用于膝关节 OA 晚期、内侧胫骨平台破坏或倾斜、外侧关节增宽和半脱位以及内外翻关节不稳定的患者。
