穹顶形胫骨高位截骨术联合半环形伊里扎洛夫外固定架固定：一种新型技术的中期至长期疗效。
Dome-shaped high tibial osteotomy with semi-circular Ilizarov pin fixator: Mid- to long-term results of a novel technique.
机构信息
Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Department of Orthopaedics and Traumatology, Istanbul, Turkey.
Kutahya Health Sciences University, Evliya Celebi Training and Research Hospital, Department of Orthopaedics and Traumatology, Kutahya, Turkey.
出版信息
Knee. 2020 Oct;27(5):1618-1626. doi: 10.1016/j.knee.2020.08.019. Epub 2020 Sep 12.
BACKGROUND
The aim of this study was to assess the clinical and radiological results of the dome-shaped high tibial osteotomy (HTO) which was fixed with a novel construct comprised of semi-circular Ilizarov frames and pins.
METHODS
The patients with at least five years of follow-up were evaluated. One-hundred and thirty-two knees of 114 patients were included in the final analysis. The clinical evaluation included range of motion and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. Anatomical femorotibial angle (aFTA), anatomical medial proximal tibial angle (aMPTA), tibial slope and Insall-Salvati ratio were calculated on standard weight-bearing radiographs.
RESULTS
The average aFTA was improved from 1.6° varus to 8.7° valgus (P < 0.001). The average WOMAC score (P < 0.001) and flexion value (P = 0.014) were improved at the latest follow-up (WOMAC: 17.2, flexion: 142.5) compared with the preoperative period (WOMAC: 59.6, flexion: 129.2). The sagittal radiological parameters were not significantly affected. The five-year survival was 96.2%, and 10-year survival was 83.3%.
CONCLUSIONS
The semi-circular Ilizarov pin construct provided satisfactory outcomes both clinically and radiologically at mid- to long-term follow-up.
背景
本研究旨在评估穹顶形高位胫骨截骨术（HTO）的临床和影像学结果，该手术采用新型半圆形伊里扎洛夫框架和钢针固定。
方法
评估至少随访 5 年的患者。最终分析包括 114 名患者的 132 个膝关节。临床评估包括关节活动度和西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分。在标准负重位 X 线片上计算解剖股骨胫骨角（aFTA）、解剖内侧胫骨近端角（aMPTA）、胫骨倾斜度和 Insall-Salvati 比值。
结果
平均 aFTA 从 1.6°内翻改善至 8.7°外翻（P<0.001）。在末次随访时，WOMAC 评分（P<0.001）和屈曲值（P=0.014）均得到改善（WOMAC：17.2，屈曲：142.5），与术前相比（WOMAC：59.6，屈曲：129.2）。矢状位影像学参数无明显变化。5 年生存率为 96.2%，10 年生存率为 83.3%。
结论
半圆形伊里扎洛夫钢针固定在中期至长期随访中提供了满意的临床和影像学结果。
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