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年龄≥70岁患者与年轻患者相比,行中立位对线内侧开放楔形高位胫骨截骨术治疗内侧间室膝关节骨关节炎后患者报告结局的术后改善情况。

Postoperative improvement in patient-reported outcomes after neutral alignment medial open wedge high tibial osteotomy for medial compartment knee osteoarthritis in patients aged ≥70 years versus younger patients.

作者信息

Nakashima Mitsuharu, Takahashi Tsuneari, Matsumura Tomohiro, Takeshita Katsushi

机构信息

Department of Orthopedic Surgery Haga Red Cross Hospital Moka Japan.

Department of Orthopedic Surgery Ishibashi General Hospital Shimotsuke Japan.

出版信息

J Exp Orthop. 2024 May 21;11(3):e12035. doi: 10.1002/jeo2.12035. eCollection 2024 Jul.

Abstract

PURPOSE

To compare the postoperative clinical and radiological outcomes in patients aged ≥70 years following neutral alignment medial opening-wedge high tibial osteotomy (NA-MOWHTO) for medial compartment knee osteoarthritis (KOA) to those observed in younger patients.

METHODS

The data of patients who underwent NA-MOWHTO for medial compartment KOA between September 2018 and June 2022 were retrospectively analysed. The patients were categorised into groups Y (<70 years) and O (≥70 years). Age, sex, Kellgren-Lawrence classification, pre- and postoperative mechanical axis, weight-bearing line ratio, medial proximal tibial angle, preoperative Tegner Activity Score and pre- and postoperative Lysholm scores were compared between the groups.

RESULTS

Overall, 81 patients (60 and 21 in groups Y and O, respectively) who underwent NA-MOWHTO were included in this study. No significant differences were found in patient characteristics between the two groups, except for the preoperative Tegner Activity Score, which was significantly higher in group Y than in group O (3 [2-4] vs. 2 [2-2], respectively;  = 0.011). The two groups exhibited no significant differences in pre- and postoperative knee alignments. Postoperatively, Lysholm scores improved significantly in both groups without significant differences. Additionally, no correlation was found between age and pre- and postoperative Lysholm scores.

CONCLUSIONS

The postoperative improvement following NA-MOWHTO for medial compartment KOA is comparable in patients aged ≥70 and younger.

LEVEL OF EVIDENCE

Level III, Retrospective comparative study.

摘要

目的

比较年龄≥70岁的内侧间室膝关节骨关节炎(KOA)患者在接受中立位对线内侧开口楔形高位胫骨截骨术(NA-MOWHTO)后的术后临床和影像学结果与年轻患者的情况。

方法

回顾性分析2018年9月至2022年6月期间因内侧间室KOA接受NA-MOWHTO的患者数据。将患者分为Y组(<70岁)和O组(≥70岁)。比较两组患者的年龄、性别、Kellgren-Lawrence分级、术前和术后机械轴、负重线比率、胫骨近端内侧角、术前Tegner活动评分以及术前和术后Lysholm评分。

结果

本研究共纳入81例行NA-MOWHTO的患者(Y组60例,O组21例)。两组患者的特征无显著差异,但术前Tegner活动评分除外,Y组显著高于O组(分别为3[2-4]和2[2-2];P = 0.011)。两组术前和术后的膝关节对线无显著差异。术后,两组的Lysholm评分均显著改善,且无显著差异。此外,年龄与术前和术后Lysholm评分之间无相关性。

结论

对于内侧间室KOA,NA-MOWHTO术后的改善在≥70岁患者和年轻患者中相当。

证据水平

III级,回顾性比较研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/139b/11109526/f51de9edd65e/JEO2-11-e12035-g001.jpg

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