Department of Orthopaedic Surgery, Konyang University Hospital, Daejeon, South Korea.
J Orthop Surg (Hong Kong). 2024 May-Aug;32(2):10225536241273889. doi: 10.1177/10225536241273889.
No comprehensive study has been conducted on the effects of high tibial osteotomy (HTO) on the coronal, sagittal, and axial alignments of the ankle joint. Therefore, this study aimed to investigate the multiplane changes in the ankle joint following HTO using the EOS biplanar X-ray imaging system.
The medical records of 43 patients who underwent HTO for the treatment of medial knee osteoarthritis were retrospectively reviewed. Preoperative and postoperative EOS images and lower-extremity scanograms were evaluated; the correlations between the outcomes were evaluated.
After HTO, the ankle joint axis point on the weight-bearing line showed significant lateralization ( < .001). The knee lateral ankle surface angle increased significantly in the sagittal alignment ( < .001). The distal tibia showed a significant internal rotation in the axial plane ( = .022). Tibial rotation showed no significant relationship with the other parameters.
HTO induced lateralization of the ankle joint axis (coronal), increased the posterior tibial slope (sagittal), and caused the internal rotation of the distal tibia (axial). Axial changes in the distal tibia showed no significant relationship with other coronal and sagittal parameters of the ankle joint. We suggest that surgeons should consider, during HTO, that the ankle joint axis shifts laterally and distal tibia has tendency to rotate internally after HTO.
目前尚未有研究全面探讨胫骨高位截骨术（HTO）对踝关节冠状位、矢状位和轴向排列的影响。因此，本研究旨在使用 EOS 双平面 X 射线成像系统研究 HTO 后踝关节的多平面变化。
回顾性分析 43 例因内侧膝骨关节炎行 HTO 治疗的患者的病历资料。评估术前和术后 EOS 图像和下肢扫描图；评估结果之间的相关性。
HTO 后，负重线上的踝关节轴线点出现明显的外侧化（<0.001）。在矢状位上，膝关节外踝面角显著增加（<0.001）。在轴向平面上，胫骨远端显示出明显的内旋（=0.022）。胫骨旋转与其他参数之间无显著关系。
HTO 引起踝关节轴线的外侧化（冠状位）、后胫骨倾斜度增加（矢状位）以及胫骨远端的内旋（轴向）。胫骨远端的轴向变化与踝关节其他冠状位和矢状位参数之间无显著关系。我们建议外科医生在进行 HTO 时应考虑到踝关节轴线会发生外侧移位，以及胫骨远端在 HTO 后有内旋的趋势。
