Shivji Faiz S, Foster Aaron, Risebury Michael J, Wilson Adrian J, Yasen Sam K
Department of Trauma and Orthopaedics, Hampshire Hospitals NHS Trust, Basingstoke and North Hampshire Hospital, Aldermaston Road, Basingstoke, RG24 9NA, Hampshire, UK.
Knee Surg Sports Traumatol Arthrosc. 2021 Feb;29(2):594-599. doi: 10.1007/s00167-020-05988-5. Epub 2020 Apr 13.
The purpose of this study was to assess the accuracy, safety, and survival of distal femoral osteotomy (DFO) surgery for lateral compartment OA of the knee.
A retrospective cohort study was conducted at a single UK centre, using prospectively collected data over an 8-year period (2009-2017). All patients had pre-operative radiographic analysis and digital planning of their deformity correction in addition to post-operative analysis of the achieved correction and yearly face-to-face follow-up. Complications (defined as an undesirable medical or surgical event as a direct result of the operation), reoperations, and failure (defined as conversion to arthroplasty or revision) were recorded.
From a total of 83 patients, 81 patients undergoing 86 primary DFOs were included in this study, with a mean follow-up of 99 months (SD 27 months). The mean pre-operative percentage Mikulicz point was 78.7% (SD 19.1%) and post-operative 35.9% (SD 14.8%). The mean accuracy of correction (intended correction - achieved correction) was an 8.2% overcorrection (SD 13.7%). The complication rate was 4.7%. Using Kaplan-Meier analysis, the mean survival was 113 months (95% CI 106-120) with the probability of surviving 10 years 89%.
DFO for valgus alignment and lateral compartment arthritis is associated with low complications, long-term joint preservation, and the prevention of arthroplasty surgery. However, the accuracy of correction still requires improvement in intra-operative technique.
IV.
本研究旨在评估股骨远端截骨术（DFO）治疗膝关节外侧间室骨关节炎的准确性、安全性及生存率。
在英国的一个中心进行了一项回顾性队列研究，使用了8年期间（2009 - 2017年）前瞻性收集的数据。所有患者术前均进行了影像学分析和畸形矫正的数字化规划，此外还进行了术后矫正效果分析及每年的面对面随访。记录并发症（定义为手术直接导致的不良医疗或手术事件）、再次手术及失败情况（定义为转为关节置换术或翻修术）。
本研究纳入了83例患者中的81例接受86次初次DFO手术的患者，平均随访时间为99个月（标准差27个月）。术前Mikulicz点的平均百分比为78.7%（标准差19.1%），术后为35.9%（标准差14.8%）。矫正的平均准确度（预期矫正 - 实际矫正）为8.2%的过度矫正（标准差13.7%）。并发症发生率为4.7%。使用Kaplan - Meier分析，平均生存率为113个月（95%置信区间106 - 120），10年生存率为89%。
DFO治疗外翻畸形和外侧间室关节炎并发症发生率低，可长期保留关节并预防关节置换手术。然而，术中技术的矫正准确度仍需提高。
IV级
