Maquet P
Clin Orthop Relat Res. 1976 Oct(120):143-8.
Recent reports indicate that proximal tibial osteotomy for osteoarthritis of the knee is contraindicated if subluxation of the joint is evident clinically or on weight-bearing X-rays, or if the angular deformity of the joint is greater than 15 degrees. The purpose of this paper is to present evidence that a proximal tibial osteotomy, properly planned and performed, can give consistently sat-sfactory results even in osteoarthritic knees which have preoperative varus deformities greater that 15 degrees or are subluxated. A proper planning requires an exact measurement of the deformity on full length X-rays, a precise preoperative drawing and a very exact osteotomy giving some overcorrection. The overcorrection must compensate for the weakness of the lateral muscles, the most frequent cause of the condition.
最近的报告表明,如果临床上或负重X线片显示膝关节明显半脱位,或者关节角畸形大于15度,那么膝关节骨关节炎的胫骨近端截骨术是禁忌的。本文的目的是提供证据表明,即使在术前内翻畸形大于15度或已半脱位的骨关节炎膝关节中,经过妥善规划和实施的胫骨近端截骨术也能持续产生令人满意的结果。妥善的规划需要在全长X线片上精确测量畸形,进行精确的术前绘图,并进行非常精确的截骨以实现一定程度的过度矫正。过度矫正必须弥补外侧肌肉的薄弱,这是导致该病症最常见的原因。