Cameron H U, Botsford D J, Park Y S
Orthopaedic & Arthritic Hospital, Tornto, Ont.
Can J Surg. 1997 Apr;40(2):114-8.
To identify the demographic and operative factors that determine outcome in supracondylar femoral osteotomy for lateral compartment osteoarthritis of the knee.
Clinical and radiologic review of a nonrandomized, consecutive one-surgeon series.
A university-affiliated, elective surgical referral centre.
Forty-nine consecutive patients with unicompartmental osteoarthritis of the knee, involving the lateral compartment, and of sufficient severity that the alternative surgical procedure would be total knee replacement.
Supracondylar varus osteotomy stabilized with a blade plate.
Knee function measured by the Knee Society Score and time to conversion to total knee replacement.
A Knee Society Score greater than 80 was obtained in 81% of patients, but in the function portion of the measurement only 30% had a similar score. After discarding the patients who died, life-table analysis demonstrated the predicted survival before conversion to total knee replacement to be 87% at 7 years. There was no correlation with patient age or sex, femorotibial angulation, amount of correction or time after the intervention. Removal of the fixation device improved the clinical result.
The role of supracondylar femoral osteotomy remains poorly defined, but the procedure can delay total knee replacement for considerable time in appropriate patients.
确定决定股骨髁上截骨术治疗膝关节外侧间室骨关节炎疗效的人口统计学和手术因素。
对一个非随机、连续的单外科医生系列病例进行临床和影像学回顾。
一所大学附属医院的择期手术转诊中心。
49例连续的膝关节单髁骨关节炎患者，累及外侧间室，病情严重程度足以使替代手术为全膝关节置换术。
采用刃形钢板固定的股骨髁上内翻截骨术。
用膝关节协会评分评估膝关节功能，以及转换为全膝关节置换术的时间。
81%的患者膝关节协会评分大于80，但在功能评分部分只有30%的患者有类似评分。剔除死亡患者后，生存分析显示转换为全膝关节置换术之前，7年的预测生存率为87%。这与患者年龄、性别、股胫角、矫正量或干预后时间均无相关性。取出固定装置可改善临床结果。
股骨髁上截骨术的作用仍不明确，但该手术可在合适的患者中相当长时间地推迟全膝关节置换术。
