Chan R N, Pollard J P
Acta Orthop Scand. 1978 Feb;49(1):78-84. doi: 10.3109/17453677809005729.
Although high tibial osteotomy for osteoarthrosis of the knee joint is well recognized, its place in the management of rheumatoid arthritis of the knee is much less well established. Thirty-six rheumatoid knees were reviewed 1 to 6 years following tibial osteotomy. The results were 42 per cent good, 19 per cent satisfactory and 39 per cent poor. No patient remained free of pain for more than 3 years, and recurrence of pain was not always associated with recurrence of deformity. Varus knees did considerably better than valgus knees despite some technical errors. Maintenance of a normal femoro-tibial angle range of 164 degrees to 177 degrees at follow-up was important but not as vital as in osteoarthrosis of the knee. The beneficial effect of tibial osteotomy in rheumatoid arthritis of the knee seldom lasted more than 3 years after which time an increasing number of bad results were seen. It was concluded that high tibial osteotomy was a satisfactory procedure for rheumatoid arthritis of the knee but its efficacy was not comparable to that seen in osteoarthrosis nor was its effect long-lasting.
尽管膝关节骨关节炎的高位胫骨截骨术已得到广泛认可，但其在膝关节类风湿性关节炎治疗中的地位却远未明确。对36例接受胫骨截骨术1至6年的类风湿性膝关节进行了回顾性研究。结果显示，42%的效果良好，19%的效果满意，39%的效果较差。没有患者能在3年以上完全无痛，疼痛复发并不总是与畸形复发相关。尽管存在一些技术失误，但内翻膝的效果明显优于外翻膝。随访时维持164度至177度的正常股骨 - 胫骨角范围很重要，但不像膝关节骨关节炎那样至关重要。胫骨截骨术对膝关节类风湿性关节炎的有益效果很少能持续超过3年，此后不良结果的数量逐渐增加。得出的结论是，高位胫骨截骨术对于膝关节类风湿性关节炎是一种令人满意的手术方法，但其疗效无法与膝关节骨关节炎相比，效果也不持久。
