Berruto M, Bianchi M, Laurà G
Centro di Chirurgia e Artroscopia del Ginocchio, Istituto Ortopedico G. Pini, Milano.
Ital J Orthop Traumatol. 1993;19(1):33-41.
Twenty-two of the 24 patients operated on with femoral supracondylar osteotomy for arthritic valgus knee between 1978 and 1987 were evaluated, comparing the results with those obtained in a similar group of 10 patients with the same disorder treated with knee replacement during the same period. From a functional viewpoint and according to the Hospital for Special Surgery rating scale, the results of the osteotomy were not significantly different from the extremely positive outcome of the knee replacement. However, as far as pain is concerned, only 50% of the osteotomy patients were completely asymptomatic after the operation. In the 50% of the osteotomy patients with post-operative under or over correction of the mechanical axis of the knee, the results were unsatisfactory. Finally, there was only one case of delayed union. In the light of these results, in contrast to what has been said by other authors, femoral osteotomy may be considered a valid alternative to knee replacement in the treatment of arthritic valgus knee in active subjects, less than 65 years old, with a valgus angulation of no more than 15 degrees and Ahlback stage 2 beta arthritis of the lateral compartment. It is, however, a technique which requires extreme precision both in planning and performing the operation.
对1978年至1987年间接受股骨髁上截骨术治疗膝关节炎外翻的24例患者中的22例进行了评估，并将结果与同期接受膝关节置换术治疗的10例患有相同疾病的类似患者组的结果进行了比较。从功能角度并根据特殊外科医院评分量表来看，截骨术的结果与膝关节置换术的极佳结果并无显著差异。然而，就疼痛而言，只有50%的截骨术患者术后完全无症状。在50%的截骨术患者中，膝关节机械轴术后出现矫正不足或过度矫正，结果并不理想。最后，只有1例延迟愈合。鉴于这些结果，与其他作者的说法相反，对于年龄小于65岁、外翻角度不超过15度且外侧间室为Ahlback 2β期关节炎的活跃患者，股骨截骨术可被视为膝关节置换术治疗膝关节炎外翻的有效替代方法。然而，这是一种在手术规划和实施过程中都需要极高精确度的技术。
