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采用定制器械的同种异体骨软骨移植和高位胫骨截骨术

Osteochondral Allograft and High Tibial Osteotomy With Patient-Specific Instrumentation.

作者信息

Selley Ryan, Itthipanichpong Thun, Menta Samarth Venkata, Ranawat Anil S

机构信息

Hospital for Special Surgery, New York, New York, USA.

Department of Orthopedic Surgery, Northwestern Memorial Hospital, Chicago, Illinois, USA.

出版信息

Video J Sports Med. 2023 Aug 23;3(4):26350254231186435. doi: 10.1177/26350254231186435. eCollection 2023 Jul-Aug.

Abstract

BACKGROUND

Medial compartment osteoarthritis in young active patients presents a unique challenge with regard to joint preservation. Interventions, including cartilage restoration procedures, in the setting of high tibial osteotomy (HTO) have the potential to obviate or delay joint replacement if performed with a high degree of accuracy and avoidance of complications.

INDICATIONS

The procedure is indicated in patients less than 65 years with isolated medial knee arthrosis, good range of motion, and no ligamentous instability.

TECHNIQUE DESCRIPTION

We present our technique for valgus producing opening wedge HTO with patient-specific instrumentation and implant with concomitant osteochondral allograft of the medial femoral condyle and tibial microfracture.

RESULTS

The goal of this intervention is to provide a minimally painful knee with durable (>10 year) outcome while minimizing the risk of perioperative complications including iatrogenic fracture and nonunion.

DISCUSSION/CONCLUSION: High tibial osteotomy with concomitant cartilage repair techniques can lead to high satisfaction and return to sport rates in appropriately selected patients.

PATIENT CONSENT DISCLOSURE STATEMENT

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

摘要

背景

年轻活跃患者的内侧间室骨关节炎在关节保留方面带来了独特的挑战。在高位胫骨截骨术(HTO)的情况下,包括软骨修复手术在内的干预措施,如果能高度精确地实施并避免并发症,就有可能避免或推迟关节置换。

适应症

该手术适用于年龄小于65岁、孤立性内侧膝关节病、活动范围良好且无韧带不稳定的患者。

技术描述

我们介绍了使用定制器械和植入物进行外翻撑开楔形HTO的技术,同时进行股骨内侧髁同种异体骨软骨移植和胫骨微骨折。

结果

该干预措施的目标是提供一个疼痛轻微且效果持久(>10年)的膝关节,同时将包括医源性骨折和骨不连在内的围手术期并发症风险降至最低。

讨论/结论:在适当选择的患者中,高位胫骨截骨术与软骨修复技术相结合可带来高满意度和高重返运动率。

患者知情同意披露声明

作者证明已获得本出版物中出现的任何患者的同意。如果个体可识别,作者已随本稿件提交了患者的豁免声明或其他书面批准形式以供发表。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d8de/11962481/afda26719be2/10.1177_26350254231186435-img1.jpg

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