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混合外侧闭合楔形高位胫骨截骨术与内侧开放楔形高位胫骨截骨术在矫正力上的差异与内翻畸形的严重程度以及距畸形中心不同的铰链距离有关。

Difference in Correction Power between Hybrid Lateral Closed-Wedge High Tibial Osteotomy and Medial Open-Wedge High Tibial Osteotomy was Associated with Severity of Varus Deformity and Different Hinge Distance from Center of Deformity.

作者信息

Jung Seok Jin, Kang Jun Ho, Rhee Seung Joon, Moon Sang Won, Wang Lih, D'Lima Darryl D

机构信息

Department of Orthopedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Republic of Korea.

College of Medicine, Pusan National University, Busan 46241, Republic of Korea.

出版信息

Diagnostics (Basel). 2024 May 29;14(11):1137. doi: 10.3390/diagnostics14111137.

Abstract

Hybrid lateral closed-wedge high tibial osteotomy (HBHTO) carries certain advantages over medial open-wedge high tibial osteotomy (OWHTO). We investigated the potential difference in the required correction angle between HBHTO and OWHTO to achieve an equal amount of whole lower-extremity alignment correction, retrospectively analyzing the preoperative plain radiographic images of 100 patients. The medial proximal tibial angle (MPTA), joint line convergence angle (JLCA), mechanical lateral distal femoral angle (mLDFA), hip-knee-ankle axis (HKA), length of the tibia, width of the tibial plateau, length of the lower limb (leg length), and location of the center of deformity (CD) were measured. Differences in the required correction angle at the hinge point between the two techniques (CAD) were compared, and correlation analysis was performed to reveal the influential factors. The mean difference in CAD between HBHTO and OWHTO was 0.78 ± 0.22 (0.41.5)°, and mean WBL position change per correction angle was 3.9 ± 0.3 (3.04.6)% in HBHTO and 4.1 ± 0.3 (3.1~4.7)% in OWHTO. Correlation analysis revealed a strong positive correlation between CAD and HKA. mLDFA, JLCA, MPTA, leg length, OWCD, HBCD, and HCD were also significantly correlated with CAD. HBHTO required a 5.6% larger correction angle at the hinge point to achieve the same amount of alignment correction as OWHTO.

摘要

混合外侧闭合楔形高位胫骨截骨术(HBHTO)相较于内侧开放楔形高位胫骨截骨术(OWHTO)具有一定优势。我们回顾性分析了100例患者的术前X线平片影像,以研究HBHTO与OWHTO为实现同等程度的全下肢对线矫正所需矫正角度的潜在差异。测量了胫骨近端内侧角(MPTA)、关节线汇聚角(JLCA)、机械性股骨远端外侧角(mLDFA)、髋-膝-踝轴线(HKA)、胫骨长度、胫骨平台宽度、下肢长度(腿长)以及畸形中心(CD)的位置。比较了两种技术在铰链点处所需矫正角度的差异(CAD),并进行相关性分析以揭示影响因素。HBHTO与OWHTO之间CAD的平均差异为0.78±0.22(0.41.5)°,HBHTO中每矫正角度的平均WBL位置变化为3.9±0.3(3.04.6)%,OWHTO中为4.1±0.3(3.1~4.7)%。相关性分析显示CAD与HKA之间存在强正相关。mLDFA、JLCA、MPTA、腿长、OWCD、HBCD和HCD也与CAD显著相关。与OWHTO相比,HBHTO在铰链点处需要大5.6%的矫正角度才能实现相同程度的对线矫正。

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