Wang X S, Huang Y, Liu J, Liu G
Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Beijing 100035, China.
Department of Orthopaedic Surgery, Beijing Chaoyang Emergency Medical Center, Beijing 100122, China.
Zhonghua Wai Ke Za Zhi. 2020 Jun 1;58(6):435-440. doi: 10.3760/cma.j.cn112139-20200227-00144.
To investigate the sagittal and torsional changes in the tibia after a medial open wedge high tibial osteotomy (OWHTO) and their correlation with the corrective angle of proximal tibial coronal plane. A prospective analysis was conducted on patients who underwent OWHTO at Department of Orthopaedic Surgery, Beijing Chaoyang Emergency Medical Center from March 2019 to July 2019.The operation were performed by the same surgeon. X-ray and CT were performed before and 3 days after the operation. The mechanical axis angle (mFTA), medial proximal tibial angle (MPTA), posterior tibial slope (PTS) and tibial torsion angle (TTA) were measured and compared by paired -test. Pearson correlation coefficient was used to analyze the correlation between the changes of PTS and TTA and the correction angle of MPTA. A total of 13 patients (19 knees) were recruited. There were 9 males (13 knees) and 4 females (6 knees), aged (39.4±14.4) years (range:20 to 60 years). The mFTA improved from (8.1±2.8) degrees preoperatively to (-1.4±1.6) degrees postoperatively (14.819, 0.000). The MPTA was changed from (81.1±2.4) degrees pre-operatively to (90.4±3.4) degrees postoperatively (-15.579, 0.000). The PTS decreased from (79.6±3.2) degrees to (76.8±3.1) degrees (9.709, 0.000). The differences of mFTA, MPTA and PTS were statistically significant. There was no significant difference in TTA between before and after operation ((28.2±1.5) ° . (27.3±6.3) °,1.925, 0.070). There was no correlation between the correction angle of MPTA and the change of PTS and TTA (0.384, 0.105; 0.321, 0.181). Even if the intra-operative measures were used to control tibial slope, the PTS still increased significantly after OWHTO, while the TTA has no significant change. No correlation was seen between the change of sagittal and torsional and the corrective angle of proximal tibial coronal plane.
探讨内侧开放楔形高位胫骨截骨术（OWHTO）后胫骨矢状面和扭转的变化及其与胫骨近端冠状面矫正角度的相关性。对2019年3月至2019年7月在北京朝阳急诊医学中心骨科接受OWHTO手术的患者进行前瞻性分析。手术由同一位外科医生进行。在术前和术后3天进行X线和CT检查。采用配对t检验测量并比较机械轴角（mFTA）、胫骨近端内侧角（MPTA）、胫骨后倾角度（PTS）和胫骨扭转角（TTA）。采用Pearson相关系数分析PTS和TTA的变化与MPTA矫正角度之间的相关性。共纳入13例患者（19膝）。其中男性9例（13膝），女性4例（6膝），年龄（39.4±14.4）岁（范围：20至60岁）。mFTA从术前的（8.1±2.8）°改善至术后的（-1.4±1.6）°（t=14.819，P=0.000）。MPTA从术前的（81.1±2.4）°变为术后的（90.4±3.4）°（t=-15.579，P=0.000）。PTS从（79.6±3.2）°降至（76.8±3.1）°（t=9.709，P=0.000）。mFTA、MPTA和PTS的差异具有统计学意义。术前和术后TTA无显著差异（（28.2±1.5）°，（27.3±6.3）°，t=1.925，P=0.070）。MPTA的矫正角度与PTS和TTA的变化之间无相关性（r=0.384，P=0.105；r=0.321，P=0.181）。即使术中采取措施控制胫骨坡度，OWHTO术后PTS仍显著增加，而TTA无显著变化。胫骨矢状面和扭转的变化与胫骨近端冠状面的矫正角度之间无相关性。
