胫骨高位截骨术治疗内翻型膝关节骨关节炎远期疗效观察

Long term Outcome of High Tibial Osteotomy for Osteoarthritis with Genu Varum.

为评价应用高位胫骨截骨术治疗内翻型膝关节骨关节炎的远期疗效，对２４例（２９膝）进行平均１０６年的随访。结果显示，８２６％疗效优良或满意。疗效与年龄有关，理想的股胫外侧角度（简称ＦＴＡ）１６８°～１７２°。５０岁以下，ＦＴＡ为１６５°～１７５°者多能获得满意以上结果。术式选用胫骨结节上楔形截骨抑或倒Ｖ截骨，应根据有无髌股关节炎而定。只要选择恰当，疗效与术式无关。

We have used high tibial osteotomy to treat osteoarthritis with genu varum and 24 cases(29 knees) were followed up for 10.6 years in average.82.6% of them had satisfactory outcome.The resullt shows that it is related between curative effect and age.Ideal femorotibial lateral angle(FTA) should be 168～172 degrees.Most of patients below 50 years old with FTA 165～175 degrees had satisfactory outcome.The result was not related with wedge osteotomy on tibial node or inversion V osteotomy.According to whether the patient had patellofemoral arthritis or not,one of above two operations was selected.For the patients below 60 years old,high tibial osteotomy should be chosen firstly for osteoarthritis with genu varum.