Screpis Daniele, Baldini Marco, Piovan Gianluca, Santamaria Fabio, Iacono Venanzio, Gigante Antonio, Zorzi Claudio
IRCCS Ospedale Sacro Cuore-Don Calabria; Viale Luigi Rizzardi 4, Negrar, VR, Italia.
Clinica Ortopedica dell'adulto e pediatrica, Università Politecnica delle Marche, Via Tronto 10/A, Ancona, AN, Italia.
BMC Musculoskelet Disord. 2024 Dec 19;25(1):1035. doi: 10.1186/s12891-024-08022-8.
Simultaneous bilateral high tibial osteotomy (SBHTO) is a potential solution to treat bilateral medial osteoarthritis (OA) associated with tibial varus deformity. Concerns on the potential problems related to bone healing exists, and most of the surgeon performing SBHTO use bone void filler as associated procedure. This paper aim to evaluate safety and efficacy of SBHTO using locking plate, autologous cancellous bone mobilization and no bone void filler with immediate weight bearing at tolerance protocol.
Consecutive patients performing primary SBHTO between January 2019 and December 2022 were retrospectively evaluated. Functional and pain score, subjective satisfaction and complications were noted at 2, 3, 6 months and final follow up, with a minimum of 12 months.
A total of 40 patients (80 knees) were included. Mean correction for each limb was 8.67° ± 2.24°. No patients presented with major complications. Pain was reduced but activity level worsened 2 months after surgery. All pain and functional scores improved significantly from months 3 up to final follow up. 95% of patients reported to be subjectively satisfied with surgery.
This paper showed that SBHTO can be performed safely and with good results without bone grafting the osteotomy gap, even for correction up to 12°. Pain improved already 2 months after surgery, while activity level and function start to improve at 3 months after surgery.
IV.
同期双侧高位胫骨截骨术（SBHTO）是治疗与胫骨内翻畸形相关的双侧内侧骨关节炎（OA）的一种潜在解决方案。人们对与骨愈合相关的潜在问题存在担忧，并且大多数进行SBHTO的外科医生会将骨缺损填充作为相关操作。本文旨在评估使用锁定钢板、自体松质骨移植且不使用骨缺损填充材料并采用耐受方案下即刻负重的SBHTO的安全性和有效性。
对2019年1月至2022年12月期间接受初次SBHTO的连续患者进行回顾性评估。记录2、3、6个月及最终随访（至少12个月）时的功能和疼痛评分、主观满意度及并发症情况。
共纳入40例患者（80膝）。每侧肢体的平均矫正角度为8.67°±2.24°。无患者出现重大并发症。术后2个月疼痛减轻但活动水平恶化。从3个月到最终随访，所有疼痛和功能评分均显著改善。95%的患者报告对手术主观满意。
本文表明，即使矫正角度达12°，SBHTO在不植骨填充截骨间隙的情况下也可安全进行且效果良好。术后2个月疼痛即有所改善，而活动水平和功能在术后3个月开始改善。
IV级。
