患者年龄对内侧开放楔形高位胫骨截骨术后临床及影像学结果的影响：一项对344例膝关节的比较研究
Effect of Patient Age on Clinical and Radiological Outcomes After Medial Open-Wedge High Tibial Osteotomy: A Comparative Study With 344 Knees.
作者信息
Yabuuchi Koji, Kondo Eiji, Kaibara Takuma, Onodera Jun, Iwasaki Koji, Matsuoka Masatake, Onodera Tomohiro, Iwasaki Norimasa, Yagi Tomonori, Yasuda Kazunori
机构信息
Department of Orthopaedic Surgery, Yagi Orthopaedic Hospital, Sapporo, Hokkaido, Japan.
Centre for Sports Medicine, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.
出版信息
Orthop J Sports Med. 2023 Oct 12;11(10):23259671231200227. doi: 10.1177/23259671231200227. eCollection 2023 Oct.
BACKGROUND
There exists some controversy regarding whether patient age is a predictive factor for outcomes after high tibial osteotomy (HTO).
PURPOSE/HYPOTHESIS: The purpose of this study was to evaluate whether patient age affects clinical and radiological outcomes after medial open-wedge HTO (OWHTO) in a large population with a wider age range than previous studies. It was hypothesized that there would be no differences in outcomes when compared across age-groups.
STUDY DESIGN
Cohort study; Level of evidence, 3.
METHODS
A retrospective comparative study was conducted using 344 patients (303 knees) who underwent OWHTO from 2009 to 2018. These patients were divided into 3 groups based on age at the time of surgery: ≥55 years (group Y: 76 knees in 57 patients), 56 to 64 years (group M: 129 knees in 120 patients), and ≤65 years (group O: 139 knees in 126 patients). Clinical and radiological evaluations were performed immediately before surgery and at the final follow-up period, at a mean of 5.1 years (range, 3-11 years). Comparisons among the 3 groups were conducted with 1-way analysis of variance for continuous variables. When a significant result was obtained, a post hoc test with Bonferroni correction was conducted for multiple comparisons.
RESULTS
In clinical evaluations, there were no significant differences among the 3 groups either preoperatively or postoperatively concerning the Japanese Orthopaedic Association score, the Lysholm score, or the Knee injury and Osteoarthritis Outcome Score (KOOS), with the exception of the preoperative KOOS Symptoms subscale, which was significantly higher in group Y versus group O (48.9 ± 18.7 vs 58.7 ± 15.4, respectively; = .011). The Tegner activity score was significantly different among the groups, both preoperatively and postoperatively ( < .001 for both). There was no significant difference in the occurrence of complications or the survival rate at final follow-up among the 3 groups.
CONCLUSION
The study findings suggest that patient age does not affect clinical and radiological outcomes after OWHTO.
背景
关于患者年龄是否为高位胫骨截骨术（HTO）术后预后的预测因素存在一些争议。
目的/假设：本研究的目的是评估在一个年龄范围比以往研究更广的大样本人群中，患者年龄是否会影响内侧开放楔形高位胫骨截骨术（OWHTO）后的临床和影像学预后。研究假设是不同年龄组之间的预后无差异。
研究设计
队列研究；证据等级，3级。
方法
采用回顾性比较研究，纳入2009年至2018年接受OWHTO的344例患者（303膝）。根据手术时的年龄将这些患者分为3组：≥55岁（Y组：57例患者76膝），56至64岁（M组：120例患者129膝），以及≤65岁（O组：126例患者139膝）。在手术前和最终随访时（平均5.1年，范围3 - 11年）进行临床和影像学评估。对连续变量采用单因素方差分析对3组进行比较。当获得显著结果时，采用Bonferroni校正的事后检验进行多重比较。
结果
在临床评估中，3组在术前或术后的日本骨科协会评分、Lysholm评分或膝关节损伤和骨关节炎结局评分（KOOS）方面均无显著差异，但术前KOOS症状子量表除外，Y组显著高于O组（分别为48.9±18.7和58.7±15.4；P = 0.011）。Tegner活动评分在术前和术后组间均有显著差异（两者P均<0.001）。3组在并发症发生率或最终随访时的生存率方面无显著差异。
结论
研究结果表明，患者年龄不影响OWHTO后的临床和影像学预后。
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