Dan Michael J, Cance Nicolas, Pineda Tomas, Demey Guillaume, Dejour David H
Lyon Ortho Clinic, Orthopedic Surgery Department, Clinique de la Sauvegarde, Lyon, France; Surgical and Orthopaedic Research Laboratory, Prince of Wales Clinical School University of New South Wales, Sydney, Australia.
Lyon Ortho Clinic, Orthopedic Surgery Department, Clinique de la Sauvegarde, Lyon, France.
Arthroscopy. 2024 Mar;40(3):846-854. doi: 10.1016/j.arthro.2023.07.007. Epub 2023 Jul 19.
To correlate changes in posterior tibial slope (PTS) with changes to static anterior tibial translation (SATT) with tibial deflexion osteotomy (TDO), in order to define a target postoperative tibial slope based on postoperative SATT.
We reviewed a consecutive series of primary and revision anterior cruciate ligament reconstruction with TDO between 2011 and 2022. PTS and SATT were measured pre- and postoperatively directly from the radiographs by 2 independent reviewers. Regression analysis was performed to investigate the relationship of postoperative SATT with PTS, gender, graft type, and meniscal injury.
A total of 48 patients were included in this study. The mean (SD) decrease in PTS and SATT was 8.85° (3.03°; 12.5° to 3.59°, P < .01), and 7.93 mm (3.68; 5.37 to -2.55 mm, P < .01), respectively. Upon univariate analysis, the only factor influencing ΔSATT was ΔPTS. For each 1° of decreased slope, SATT was reduced by 0.46 mm. The mean (SD) PTS for a negative SATT was 2.81° (2.78°) compared to 5.09° (3.25°) for a SATT of 0 to 5mm (P < .01).
This study reports weightbearing SATT in association with PTS after TDO. The TDO successfully reduced the SATT, with the change in PTS the only significant predictor of postoperative SATT. Based on our results, our previously held target of 2° to 5° PTS overcorrected the SATT. Therefore, considering as a goal 0 to 5 mm of SATT, we suggest a new target of 4° to 6° PTS.
Level IV, retrospective cohort study.
将胫骨后倾截骨术（TDO）后胫骨后倾坡度（PTS）的变化与静态胫骨前移（SATT）的变化相关联，以便根据术后SATT确定目标术后胫骨坡度。
我们回顾了2011年至2022年间连续进行的一系列采用TDO的初次和翻修前交叉韧带重建病例。由2名独立的评估人员直接从X线片测量术前和术后的PTS和SATT。进行回归分析以研究术后SATT与PTS、性别、移植物类型和半月板损伤之间的关系。
本研究共纳入48例患者。PTS和SATT的平均（标准差）降低分别为8.85°（3.03°；从12.5°降至3.59°，P <.01）和7.93 mm（3.68；从5.37降至-2.55 mm，P <.01）。单因素分析显示，影响ΔSATT的唯一因素是ΔPTS。坡度每降低1°，SATT减少0.46 mm。SATT为负值时的平均（标准差）PTS为2.81°（2.78°），而SATT为0至5mm时为5.09°（3.25°）（P <.01）。
本研究报告了TDO后负重状态下的SATT与PTS的关系。TDO成功降低了SATT，PTS的变化是术后SATT的唯一重要预测因素。根据我们的结果，我们之前设定的2°至5°PTS目标对SATT进行了过度矫正。因此，考虑将SATT目标设定为0至5 mm，我们建议新的PTS目标为4°至6°。
IV级，回顾性队列研究。
