Rinonapoli E, Mancini G B, Corvaglia A, Musiello S
Dipartimento di Specialità Medico-Chirurgiche, Università di Perugia, Italy.
Clin Orthop Relat Res. 1998 Aug(353):185-93.
From 1975 to 1986, 102 high tibial osteotomies for varus gonarthrosis were performed in 99 patients. Fifty-eight patients (60 knees) were reviewed at an average followup of 15 years (range, 10-21 years); of the remaining 41 patients, seven had a knee replacement, 18 had died, and 16 were lost to followup. The results, assessed according to the scoring system of the Hospital for Special Surgery and including the seven patients who underwent a knee replacement, were excellent or good in 37 (55%) knees and fair or poor in 30 (45%). Twenty-six patients of the current study previously were reviewed in 1986, with an average followup of 8 years, using the same clinical and radiographic criteria. In this group of 26 patients, excellent and good results decreased from 73% in 1986 to 46% in 1996. The knees in these 26 patients with a followup greater than 15 years had a statistically significant higher percentage of fair and poor results. No statistically significant differences in the results were found according to the amount of correction. Radiographic controls at followup were available for 45 of the 60 knees; a loss of correction greater than 5 degrees was observed in 11 knees. The results of this long-term followup study show that high tibial osteotomy for gonarthrosis allows a long period (range, 10-15 years) of relief of pain, good range of motion, and function in a large number of patients. Results tend to deteriorate with time, particularly after 15 years.
1975年至1986年，对99例患者实施了102例用于治疗膝内翻性膝关节炎的高位胫骨截骨术。对58例患者（60膝）进行了平均15年（范围10 - 21年）的随访；其余41例患者中，7例行膝关节置换术，18例死亡，16例失访。根据特种外科医院评分系统评估结果，包括7例行膝关节置换术的患者，60膝中37膝（55%）结果为优或良，30膝（45%）结果为中或差。本研究中的26例患者曾在1986年接受过评估，平均随访8年，采用相同的临床和影像学标准。在这26例患者中，优和良的结果从1986年的73%降至1996年的46%。这26例随访时间超过15年的患者，结果为中或差的比例在统计学上显著更高。根据矫正量未发现结果有统计学显著差异。60膝中有45膝在随访时有影像学对照；11膝观察到矫正丢失大于5度。这项长期随访研究结果表明，用于治疗膝关节炎的高位胫骨截骨术能使大量患者在较长时间（范围10 - 15年）内缓解疼痛、保持良好的活动范围和功能。结果往往随时间恶化，尤其是在15年后。
