Kikuchi Kentaro, Kumagai Ken, Yamada Shunsuke, Nejima Shuntaro, Choe Hyonmin, Ike Hiroyuki, Kobayashi Naomi, Inaba Yutaka
Department of Orthopaedic Surgery, Graduate School of Medicine, Yokohama City University, Yokohama 236-0004, Japan.
Department of Orthopaedic Surgery, Yokohama City University Medical Center, Yokohama 232-0024, Japan.
SICOT J. 2024;10:21. doi: 10.1051/sicotj/2024020. Epub 2024 May 30.
This study aimed to investigate the anterior-posterior (AP) displacement of the tibial tuberosity (TT) and to assess the difference between closed wedge and opening wedge high tibial osteotomies (OWHTO and CWHTO).
One hundred consecutive knees with osteoarthritis that underwent OWHTO (50 knees) or CWHTO (50 knees) were investigated retrospectively. The femorotibial angle (FTA) was measured on AP radiographs of the knee. AP displacement of the TT, posterior tibial slope (PTS), the modified Blackburne-Peel index (mBPI), and the modified Caton-Deschamps index (mCDI) were measured on lateral radiographs of the knee.
Patients had a mean correction angle of 12.58 ± 2.84° and 18.98 ± 5.14° (P < 0.001), with a mean AP displacement of TT of 0.84 ± 2.66 mm and 7.78 ± 3.41 mm (P < 0.001) in OWHTO and CWHTO, respectively. The AP displacement of the TT per correction of 1° was significantly greater in CWHTO than in OWHTO (P < 0.001). A significant correlation was found between the correction angle and AP displacement of the TT in CWHTO (r = -0.523, P < 0.001), but not in OWHTO. The change of PTS per correction of 1° was significantly greater in OWHTO than in CWHTO (P < 0.001). The changes of mBPI and mCDI per correction of 1° were significantly greater in CWHTO than in OWHTO (P < 0.001 and P < 0.001, respectively).
There was greater anterior displacement of the TT in CWHTO than in OWHTO, which was correlated with the correction angle. The results suggested that CWHTO would be better than OWHTO when a concomitant anteriorization of TT is required.
本研究旨在调查胫骨结节(TT)的前后移位情况,并评估闭合楔形和开放楔形高位胫骨截骨术(OWHTO和CWHTO)之间的差异。
回顾性研究100例连续接受OWHTO(50例膝关节)或CWHTO(50例膝关节)治疗的骨关节炎患者。在膝关节前后位X线片上测量股胫角(FTA)。在膝关节侧位X线片上测量TT的前后移位、胫骨后倾坡度(PTS)、改良Blackburne-Peel指数(mBPI)和改良Caton-Deschamps指数(mCDI)。
OWHTO组和CWHTO组患者的平均矫正角度分别为12.58±2.84°和18.98±5.14°(P<0.001),TT的平均前后移位分别为0.84±2.66mm和7.78±3.41mm(P<0.001)。CWHTO组每矫正1°时TT的前后移位显著大于OWHTO组(P<0.001)。CWHTO组中矫正角度与TT的前后移位之间存在显著相关性(r=-0.523,P<0.001),而OWHTO组中未发现这种相关性。OWHTO组每矫正1°时PTS的变化显著大于CWHTO组(P<0.001)。CWHTO组每矫正1°时mBPI和mCDI的变化显著大于OWHTO组(分别为P<0.001和P<0.001)。
CWHTO组中TT的前移位大于OWHTO组,且与矫正角度相关。结果表明,当需要同时使TT前移时,CWHTO可能优于OWHTO。