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[膝关节病变的胫骨旋转截骨术:适应症、手术技术及当前文献综述]

[Tibial derotation osteotomy for knee joint pathologies : Indications, surgical technique and overview of the current literature].

作者信息

Liebensteiner Michael, Appel-Ersek Clelia, Kaufmann Gerhard, Neubauer Markus, Neugebauer Johannes, Dammerer Dietmar

机构信息

Orthopädie f. Hüfte, Knie & Fuß im Zentrum, Innrain 2, Innsbruck, Österreich.

Privatklinik Kettenbrücke, Sennstr. 1, Innsbruck, Österreich.

出版信息

Orthopadie (Heidelb). 2025 Jul 14. doi: 10.1007/s00132-025-04675-y.

Abstract

Pathological torsions of the femur and tibia are common. The negative effects on the knee are evident and do not only affect the patellofemoral joint. The suspected diagnosis of maltorsion is generated by physical examination and verified by tomographic imaging (MRI or CT). The literature review regarding tibial derotation osteotomies conducted by the authors yielded 35 studies (1562 osteotomies). Almost all of the studies reported a significant improvement compared to preoperatively based on patient-reported outcomes (Kujala, SF-36, Lysholm, KOOS, VAS and general patient wellbeing). Due to the lack of comparative studies, the best surgical technique for tibial derotation osteotomy is still undetermined. For complex cases in which deformities in several body planes are to be corrected (e.g., maltorsion and valgus varus deformity), three-dimensional planning and implementation using patient-specific incision blocks seems promising.

摘要

股骨和胫骨的病理性扭转很常见。其对膝关节的负面影响很明显,且不仅影响髌股关节。股骨扭转不良的疑似诊断通过体格检查得出,并通过断层成像(MRI或CT)进行验证。作者进行的关于胫骨旋转截骨术的文献综述共纳入35项研究(1562例截骨术)。几乎所有研究均报告,基于患者报告的结果(库亚拉评分、SF-36量表、利绍姆评分、膝关节损伤和骨关节炎疗效评分、视觉模拟评分以及患者总体健康状况),与术前相比有显著改善。由于缺乏对照研究,胫骨旋转截骨术的最佳手术技术仍未确定。对于需要矫正多个身体平面畸形的复杂病例(如扭转不良和膝内翻/膝外翻畸形),使用患者特异性切口导板进行三维规划和实施似乎很有前景。

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