Zhu J W, Chen D S, Wang T F, Zhao J W, Xie Y
Department of Sports Medicine and Arthroscopy, Tianjin Hospital, Tianjin 300210, China.
Zhonghua Wai Ke Za Zhi. 2020 Jun 1;58(6):447-451. doi: 10.3760/cma.j.cn112139-20200228-00152.
To analyze the incidence of recent complications in patients with osteoarthritis of the knee (OA) after medial opening wedge high tibial osteotomy(MOWHTO) and its influence on clinical effect. The clinical data of 131 patients with knee OA who received MOWHTO at Department of Sports Medicine and Arthroscopy,Tianjin Hospital from April 2017 to September 2018 were analyzed retrospectively. There were 75 males and 56 females, aged (62.8±5.1) years (range:48 to 70 years). Complications and clinical outcomes of patients were recorded and the proximal medial angle of tibia (MPTA), the International Knee Documentation Committee Subjective Knee Form (IKDC), the Western Ontario and McMaster Universities(WOMAC) Osteoarthritis Index and Knee Injury and Osteoarthritis Outcome score(KOOS) were collected before and 1 year after operation and compared between complication group and non-complication group. Data were analyzed by paired-samples test, independent samples test and χ(2) test. The follow-up time was (18.5±3.4) months (range:13 to 22 months). Complications occurred in 22 patients(16.8%), including 8 cases(6.1%) of hematoma, 5 cases(3.8%) of neurosensory abnormality, 4 cases(3.1%) of intramuscular venous thrombosis, 2 cases(1.5%) of deep venous thrombosis, 3 cases(2.3%) of loss of correction angle, 3 cases(2.3%) of superficial infection, 2 cases(1.5%) of deep infection, 2 cases(1.5%) of delayed union of fracture, 1 case(0.8%) of postoperative stiffness, 1 case (0.8%) of hinge point cortex fracture. There were no significant difference in MPTA ((86.5±2.0)° . (86.7±2.1)°, 0.41, 0.68) , IKDC ((86.4±4.8) .(85.5±6.9), 0.74, 0.50) , WOMAC ((87.7±6.5) . (86.1±5.8), 1.16, 0.25). There were no significant difference in knee scores except for the KOOS pain score ((79.4±4.4) . (87.2±5.9), -5.90, <0.01) and sports and recreation score ((83.2±3.0) . (88.0±4.7), 6.14, 0.01) . Short-term complications of MOWHTO can be managed appropriately through early diagnosis and individualized treatment and have no significant negative effect on knee function recovery of patients.
分析膝关节骨关节炎（OA）患者行内侧开口楔形高位胫骨截骨术（MOWHTO）后近期并发症的发生率及其对临床疗效的影响。回顾性分析2017年4月至2018年9月在天津市天津医院运动医学与关节镜科接受MOWHTO的131例膝关节OA患者的临床资料。其中男性75例，女性56例，年龄（62.8±5.1）岁（范围：48至70岁）。记录患者的并发症及临床结局，并收集术前及术后1年的胫骨近端内侧角（MPTA）、国际膝关节文献委员会主观膝关节评分表（IKDC）、西安大略和麦克马斯特大学（WOMAC）骨关节炎指数以及膝关节损伤和骨关节炎结局评分（KOOS），并在并发症组和非并发症组之间进行比较。采用配对样本t检验、独立样本t检验和χ²检验进行数据分析。随访时间为（18.5±3.4）个月（范围：13至22个月）。22例患者（16.8%）出现并发症，包括血肿8例（6.1%）、神经感觉异常5例（3.8%）、肌内静脉血栓形成4例（3.1%）、深静脉血栓形成2例（1.5%）、矫正角度丢失3例（2.3%）、浅表感染3例（2.3%）、深部感染2例（1.5%）、骨折延迟愈合2例（1.5%）、术后僵硬1例（0.8%）、铰链点皮质骨折1例（0.8%）。MPTA（（86.5±2.0）° 、（86.7±2.1）°，0.41，0.68）、IKDC（（86.4±4.8） 、（85.5±6.9），0.74，0.50）、WOMAC（（87.7±6.5） 、（86.1±5.8）, 1.16, 0.25）差异均无统计学意义。除KOOS疼痛评分（（79.4±4.4） 、（87.2±5.9），-5.90，<0.01）和运动与娱乐评分（（83.2±3.0） 、（88.0±4.7），6.14，0.01）外，膝关节评分差异均无统计学意义。MOWHTO的短期并发症可通过早期诊断和个体化治疗得到妥善处理，对患者膝关节功能恢复无明显负面影响。
