Department of Orthopedic, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
J Orthop Surg Res. 2023 Oct 17;18(1):780. doi: 10.1186/s13018-023-04281-8.
Posterior tibial slope (PTS) alterations following open-wedge high tibial osteotomy (OWHTO) can cause instability and excessive tibial translation in the sagittal plane. These changes can be influenced by the type of fixation. This study aims to compare PTS changes between patients undergoing OWHTO with Puddu plate or TomoFix plate fixation.
In this retrospective cohort study, we included 104 knees from 85 patients undergoing OWHTO, with a mean age of 41.98 ± 9.95 years; 51.8% of the participants were male. Seventy-two knees were fixed with Puddu plates, while 32 knees were fixed with TomoFix plates. PTS changes, demographic factors, Cincinnati Knee Rating Score (CKRS), Tegner-Lysholm score (TLS), length of stay (LOS), and complications were evaluated. PTS changes were measured preoperatively, immediately postoperatively, and at the 6-month follow-up.
Demographic factors were similar between the Puddu plate and TomoFix groups. There were no significant differences in preoperative, postoperative, or follow-up PTS measurements between the two groups. PTS changes were not significant in the TomoFix group postoperatively or at follow-up. However, the Puddu plate group showed a significant increase in PTS both postoperatively (P = 0.027) and at follow-up (P = 0.014). CKRS, TLS, LOS, and complications did not significantly differ between the groups.
While overall PTS changes did not significantly differ between the Puddu Plate and TomoFix Plate groups, analyzing changes within each group revealed distinct results. TomoFix fixation exhibited nonsignificant PTS changes, while Puddu plate fixation resulted in a significant increase in PTS after surgery and at the 6-month follow-up. Our findings suggest that the choice of fixation may influence PTS changes after OWHTO.
Level III.
胫骨后倾角（PTS）在开放式楔形胫骨高位截骨术（OWHTO）后发生改变可能导致矢状面不稳定和胫骨过度平移。这些变化可能受固定类型的影响。本研究旨在比较采用 Puddu 板或 TomoFix 板固定行 OWHTO 后 PTS 的变化。
在这项回顾性队列研究中，我们纳入了 85 名患者的 104 个膝关节行 OWHTO，平均年龄为 41.98±9.95 岁；51.8%的参与者为男性。72 个膝关节采用 Puddu 板固定，32 个膝关节采用 TomoFix 板固定。评估 PTS 变化、人口统计学因素、辛辛那提膝关节评分（CKRS）、Tegner-Lysholm 评分（TLS）、住院时间（LOS）和并发症。术前、术后即刻和术后 6 个月时测量 PTS 变化。
Puddu 板和 TomoFix 组的人口统计学因素相似。两组间术前、术后或随访时 PTS 测量值无显著差异。TomoFix 组术后或随访时 PTS 变化无显著差异。然而，Puddu 板组术后（P=0.027）和随访时（P=0.014）PTS 显著增加。两组间 CKRS、TLS、LOS 和并发症无显著差异。
虽然总体 PTS 变化在 Puddu 板和 TomoFix 板组间无显著差异，但分析每组内的变化得出了不同的结果。TomoFix 固定表现出 PTS 无显著变化，而 Puddu 板固定导致术后和术后 6 个月 PTS 显著增加。我们的发现表明，固定选择可能影响 OWHTO 后 PTS 的变化。
III 级。
Zotero 插件