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单侧膝关节骨关节炎患者内侧开口楔形高位胫骨截骨术中使用可变固定的阳性结果:一项观察性临床研究。

Positive Results Using Variable Fixation in Medial Opening Wedge High Tibial Osteotomies in Patients with Unilateral Knee Osteoarthritis: An Observational Clinical Investigation.

作者信息

Colcuc Christian, Vordemvenne Thomas, Beyer Georg, Leimkühler Philipp, Wähnert Dirk

机构信息

Bielefeld University, Medical School and University Medical Center OWL, Protestant Hospital of the Bethel Foundation, Department of Trauma Surgery and Orthopedics, 33617 Bielefeld, Germany.

出版信息

J Clin Med. 2024 Dec 17;13(24):7707. doi: 10.3390/jcm13247707.

Abstract

Medial opening wedge high tibial osteotomy (HTO) treats medial knee osteoarthritis by realigning the knee joint, though it still carries quite a high risk of complications. A new Variable Fixation Locking Screw technology, designed to gradually reduce construct stiffness and promote bone healing, aims to address these issues. This observational study evaluates the safety and effectiveness of this innovative approach in improving clinical outcomes. Data were prospectively collected on a cohort of the first ten consecutive patients (over 18 years of age) who underwent corrective medial opening wedge high tibial osteotomy using Variable Fixation Locking Screws (VFLSs). The procedure followed the standard surgical technique, with osteotomies stabilized using a Tomofix plate and a combination of standard locking screws and VFLSs. This study aimed to evaluate outcomes such as fracture healing, patient safety, and procedural success at 6 and 12 weeks and at 6 months. No complications, side effects, or need for implant removal were observed. By six months, 70% of patients showed radiographic and clinical healing, and 100% of patients achieved full functional recovery without any issues like length discrepancy, instability, pain, or joint stiffness. This first clinical observation study indicates that Variable Fixation Locking Screws are safe and effective for medial opening wedge high tibial osteotomies, showing promising results in reducing the risk of delayed closure or non-closure of the wedge. Further studies with a larger patient population are needed to confirm their effectiveness.

摘要

内侧开口楔形高位胫骨截骨术(HTO)通过重新调整膝关节力线来治疗膝关节内侧骨关节炎,不过其并发症风险仍然相当高。一种旨在逐渐降低内固定刚度并促进骨愈合的新型可变固定锁定螺钉技术,旨在解决这些问题。这项观察性研究评估了这种创新方法在改善临床结果方面的安全性和有效性。前瞻性收集了连续接受使用可变固定锁定螺钉(VFLS)进行矫正性内侧开口楔形高位胫骨截骨术的首批10例患者(年龄超过18岁)的数据。手术遵循标准手术技术,使用Tomofix钢板以及标准锁定螺钉和VFLS的组合来稳定截骨部位。本研究旨在评估6周、12周和6个月时的骨折愈合、患者安全性和手术成功率等结果。未观察到并发症、副作用或植入物取出的需求。到6个月时,70%的患者显示出影像学和临床愈合,100%的患者实现了完全功能恢复,没有出现任何诸如肢体长度差异、不稳定、疼痛或关节僵硬等问题。这项首次临床观察研究表明,可变固定锁定螺钉用于内侧开口楔形高位胫骨截骨术是安全有效的,在降低楔形延迟闭合或不闭合风险方面显示出有前景的结果。需要更大规模患者群体的进一步研究来证实其有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2734/11678760/1e8b420c2bf0/jcm-13-07707-g001.jpg

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