Nazem Khalilalah, Baniasadi Mojtaba, Mohammadsharifi Ghasem, Rastegar Shirvan, Talebi Sina
Department of Orthopedics, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2020 Jul 27;9:29. doi: 10.4103/abr.abr_219_19. eCollection 2020.
Lower extremity genu varum is a common deformity leading to imbalanced weight distribution on the knee joint and eventually significant disabilities due to medial compartment joint osteoarthritis. This study was aimed to assess the efficacy of a novel technique of high tibial open wedge osteotomy plus tubercle osteotomy in a follow-up study.
This is a prospective census cross-sectional study conducted on 146 patients with the history of genu varus undergone high tibial open-wedge osteotomy and tubercle osteotomy since 2011. The study population was followed within 6 months regarding tibial slope angle and medial proximal tibial angle alterations and operation-related complications, including venous phlebitis, nerve, and arterial injury, deep and superficial infection, mal-, non- and delayed-union.
146 patients with the mean age of 25.66 ± 4.23 years, and predominance of male gender (60.3%) were evaluated. Mean of tibia slope and MPTA before the surgical procedure was 9.38 ± 0.85 and 79.45 ± 2.11 that turned to 7.10 ± 0.84 and 89.74 ± 1.52 postoperatively, respectively ( < 0.001). Arterial and peroneal nerve injury was not detected in any of the cases. Deep-vein phlebitis, superficial infection, and delayed-union, malunion, and nonunion were presented in 2.05%, 1.36%, and 2.05%, respectively.
Outcomes of this study showed significant improvement in the tibia slope angle and MPTA postoperatively. Surgical-associated complications were negligible and rehabilitated by performing appropriate medical/surgical approaches. Considering the number of assessed population, HTO plus tubercle osteotomy seems an acceptable approach for genu varum treatment.
下肢膝内翻是一种常见的畸形，会导致膝关节重量分布失衡，并最终因内侧间室关节骨关节炎而导致严重残疾。本研究旨在通过一项随访研究评估一种新型的高位胫骨开放楔形截骨术加结节截骨术的疗效。
这是一项前瞻性普查横断面研究，对自2011年以来接受高位胫骨开放楔形截骨术和结节截骨术的146例膝内翻患者进行。对研究人群在6个月内随访胫骨倾斜角和胫骨近端内侧角的变化以及手术相关并发症，包括静脉炎、神经和动脉损伤、深部和浅部感染、畸形愈合、不愈合和延迟愈合。
评估了146例患者，平均年龄25.66±4.23岁，男性占优势（60.3%）。手术前胫骨倾斜角和MPTA的平均值分别为9.38±0.85和79.45±2.11，术后分别变为7.10±0.84和89.74±1.52（<0.001）。所有病例均未检测到动脉和腓总神经损伤。深静脉炎、浅部感染、延迟愈合、畸形愈合和不愈合的发生率分别为2.05%、1.36%和2.05%。
本研究结果显示术后胫骨倾斜角和MPTA有显著改善。手术相关并发症可忽略不计，通过适当的医学/手术方法可康复。考虑到评估人群的数量，高位胫骨截骨术加结节截骨术似乎是治疗膝内翻的一种可接受的方法。
