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[胫骨近端截骨术的长期疗效]

[Long-term results of tibial head osteotomy].

作者信息

Hassenpflug J, von Haugwitz A, Hahne H J

机构信息

Orthopädische Universitätsklinik Kiel.

出版信息

Z Orthop Ihre Grenzgeb. 1998 Mar-Apr;136(2):154-61. doi: 10.1055/s-2008-1051298.

Abstract

QUESTION

Long term outcome after high tibial osteotomies is essential too for the actual indication of these procedures. Complications and success rate were analysed in our patients in order to find out predictive determinants for the outcome.

METHOD

200 high tibial osteotomies were performed at the Orthopaedic clinic of Kiel University between 1974 and 1983. 148 knees (74%) could be reviewed with an average follow-up period of 10 years. 103 knees were personally examined, 45 cases were investigated by questionnaire.

RESULTS

74% were content with the result of the operation. Deterioration of complaints could be stopped in many cases, although the radiographic changes were not parallel to subjective relief of pain. The survival rate without implantation of knee prostheses was 96% 12 years postoperatively. In 10 cases which had continuous complaints knee arthroplasties were performed one to two years after high tibial osteotomy. 6 knees required additional surgery because of loss of correction. Serious complications did not occur apart from one peroneal nerve palsy and two deep though completely healed infections.

CONCLUSION

High tibial osteotomy in a modified procedure according to Coventry thus guarantees long term success with low risk of failure only.

摘要

问题

高位胫骨截骨术的长期疗效对于这些手术的实际适应证也至关重要。为了找出影响疗效的预测因素,我们对患者的并发症和成功率进行了分析。

方法

1974年至1983年间,基尔大学骨科诊所进行了200例高位胫骨截骨术。其中148例膝关节(74%)得到随访,平均随访时间为10年。对103例膝关节进行了亲自检查,45例通过问卷调查进行了调查。

结果

74%的患者对手术结果满意。在许多病例中,症状的恶化得以停止,尽管影像学改变与主观疼痛缓解并不平行。术后12年未植入膝关节假体的生存率为96%。10例持续有症状的患者在高位胫骨截骨术后一至两年进行了膝关节置换术。6例膝关节因矫正丢失需要再次手术。除1例腓总神经麻痹和2例深部但已完全愈合的感染外,未发生严重并发症。

结论

根据考文垂改良术式进行的高位胫骨截骨术仅能保证长期成功且失败风险较低。

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