Jiading Branch of Shanghai General Hospital, Jiading District Jiangqiao Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Int Orthop. 2024 Feb;48(2):481-486. doi: 10.1007/s00264-023-05959-8. Epub 2023 Sep 19.
This is a retrospective study and aims to investigate the clinical outcomes of patients with knee varus deformity and extruded medial meniscus who underwent arthroscopic meniscus centralization and medial opening wedge high tibial osteotomy.
A total of 24 patients were included in the trial, and arthroscopy intraoperative photographs and standing preoperative and postoperative radiographs were taken to analyze the mechanical tibiofemoral angle and tibial plateau inclination. Postoperative complications and knee motion were recorded, and the surgical results were evaluated using the knee society score.
The study observed four cases of surgery-related complications among all patients, but no major complications were reported. The surgery significantly improved knee flexion degrees and total knee range of motion. Satisfactory outcomes were shown in postoperative radiographs and secondary intraoperative photographs. The knee score increased from 39.6 ± 10.0 to 80.1 ± 9.0, and the functional score improved from 48.1 ± 6.9 to 89.4 ± 5.5. The preoperative tibial plateau inclination was 5.3 ± 0.7, while the postoperative data showed a decrease to 4.2 ± 0.7. The preoperative mechanical tibiofemoral angle was - 7.7 ± 1.0, and it improved in all patients postoperatively to 2.8 ± 0.9.
By alternating the knee biomechanics and significantly improving symptoms and quality of life, arthroscopic medial meniscus centralization and medial open wedge high tibial osteotomy units are confirmed to be an effective alternative treatment for knee varus deformity.
本研究为回顾性研究,旨在探讨关节镜下半月板中央固定术联合内侧开放楔形胫骨高位截骨术治疗膝内翻畸形伴内侧半月板挤岀患者的临床疗效。
本研究共纳入 24 例患者,术中拍摄关节镜下照片,术前及术后拍摄站立位 X 线片,分析机械胫股角和胫骨平台倾斜度。记录术后并发症和膝关节运动情况,采用膝关节学会评分评估手术效果。
所有患者中观察到 4 例与手术相关的并发症,但均无重大并发症。手术显著改善了膝关节的屈曲度和膝关节总活动度。术后 X 线片和二次术中照片显示满意的结果。膝关节评分从 39.6±10.0 分提高到 80.1±9.0 分,功能评分从 48.1±6.9 分提高到 89.4±5.5 分。术前胫骨平台倾斜度为 5.3±0.7,术后数据显示下降至 4.2±0.7。术前机械胫股角为-7.7±1.0,所有患者术后均改善至 2.8±0.9。
通过改变膝关节生物力学,明显改善症状和生活质量,证实关节镜下内侧半月板中央固定术联合内侧开放楔形胫骨高位截骨术单元是治疗膝内翻畸形的有效替代方法。