内侧撑开胫骨高位截骨骨性合页与胫骨平台后倾角改变的三维CT模型研究

The Effect of Hinge Direction on Posterior Tibial Slope in Medial Open-wedge High Tibial Osteotomy:A Study Based on Three-dimensional Computed Tomography Modelling

目的:探讨在内侧撑开胫骨高位截骨矫正膝内翻术后胫骨平台后倾角改变的影响因素。方法:通过对CT数据进行三维重建建立胫骨近端模型,并以此模拟内侧撑开胫骨高位截骨术,分析截骨矫正过程中合页轴的方向及内翻矫正程度与术后胫骨平台后倾角变化之间的关系。结果:与标准矢状位前后方向相比,合页轴的方向指向前外侧方向会导致术后胫骨平台后倾角增加;同时较大内翻矫正角度也导致术后胫骨平台后倾角增加较多。结论:内侧撑开胫骨高位截骨术后胫骨平台后倾角的变化与截骨矫正过程中合页轴的方向及内翻矫正程度密切相关。

Objective To explore factors affecting posterior tibial slope changes after the medial open- wedge high tibial osteotomy. Methods The open-wedge high tibial osteotomy was simulated and performed on the three-dimensional proximal tibia model reconstructed based on the computed tomography （CT） scanning, and the roles of hinge axis direction and correction of genu varum in postoperative posterior tibial slope changes were analyzed separately. Results Hinge axis pointing anterolaterally was significantly associated with the increase of postoperative posterior tibial slope with regard to the axis along the anterior-posterior direction. Meanwhile,the correction of the genu varum at a larger angle was also a crucial factor for the increase of postoperative posterior tibial slopes. Conclusion Postoperative posterior tibial slope changes after open-wedge high tibial osteotomy is closely associated with the hinge axis direction and correcting angle of the genu varum.