Saito Hidetomo, Yonekura Akihiko, Saito Kimio, Shimada Yoichi, Yamamura Toshiaki, Sato Takahiro, Nozaka Koji, Kijima Hiroaki, Fujii Masashi, Kawano Tetsuya, Murata Shohei, Miyakoshi Naohisa
Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Hondo 1-1-1, 010-8543, Akita, Japan.
Akita Sports Arthroscopy and Knee Group (ASAKG), Japan.
Asia Pac J Sports Med Arthrosc Rehabil Technol. 2020 Dec 31;24:9-13. doi: 10.1016/j.asmart.2020.11.001. eCollection 2021 Apr.
High tibial valgus osteotomy (HTO) is a well-established surgical procedure to correct a varus malalignment and treat medial compartment osteoarthritis. Recently, double level osteotomy (DLO) was recommended for extensive varus knees as a single level osteotomy (SLO) approach may create an excessive joint line obliquity and eventually result in a new bony deformity. However, a severe varus knee in cases of advanced osteoarthritis involves not only a bony deformity (extra-articular deformity) but also a medial joint space narrowing with a widened lateral joint space (intra-articular deformity). A DLO alone cannot reduce this intra-articular deformity. However, tibial condylar valgus osteotomy (TCVO) can complement DLO as to reduce this intra-articular deformity. This technical note describes a novel modified DLO procedure associated with TCVO which can restore a normal alignment and a joint line and achieve joint preservation even in cases of extensive varus osteoarthritis.
高位胫骨外翻截骨术（HTO）是一种成熟的外科手术，用于纠正内翻畸形并治疗内侧间室骨关节炎。最近，对于严重内翻膝关节，推荐采用双平面截骨术（DLO），因为单平面截骨术（SLO）可能会导致关节线过度倾斜，并最终导致新的骨畸形。然而，晚期骨关节炎患者的严重内翻膝关节不仅存在骨畸形（关节外畸形），还存在内侧关节间隙变窄和外侧关节间隙增宽（关节内畸形）。单纯的DLO无法纠正这种关节内畸形。然而，胫骨髁外翻截骨术（TCVO）可以作为DLO的补充，以减少这种关节内畸形。本技术说明描述了一种与TCVO相关的新型改良DLO手术，即使在广泛的内翻性骨关节炎病例中，该手术也能恢复正常对线和关节线，并实现关节保留。
