Background: Biplanar medial opening wedge high tibial osteotomy (MOWHTO) is a treatment method that allows adequate correction of symptomatic varus knee deformity. However, MOWHTO tends to decrease patellar height and...Background: Biplanar medial opening wedge high tibial osteotomy (MOWHTO) is a treatment method that allows adequate correction of symptomatic varus knee deformity. However, MOWHTO tends to decrease patellar height and increase the posterior tibial slope, which can affect the knee joint stability. Objective: The aim of this study was to describe the technique of biplanar MOWHTO and fixation by TomoFix plate, as well as to evaluate the accuracy of the planned correction and the postoperative tibial slope. Patients and Methods: This prospective cohort study was conducted on patients who presented with varus knee deformity and underwent biplanar MOWHTO and fixation by TomoFix plate during the period from March 2016 to March 2017. Assessment of patients included pre- and postoperative Knee and function scores, mechanical femorotibial angle (mFTA), posterior tibial slope angle (pTSA), range of motion (ROM) and radiological evaluation of the healing of the osteotomy site. Results: The recruited patients were 13 (8 men and 5 women), with average age 31.7 years old. The knee and functional scores improved from the preoperative mean of 45 and 41 to the postoperative mean of 85 and 72 points, respectively. The average knee flexion was 115 degrees, which at the final follow-up remained unchanged except for one case. The mean preoperative mFTA was 13.5°varus and decreased post-operatively to a mean of 3°valgus. The average postoperative follow-up period was 12 months (10 - 18 M). Conclusion: The biplanar MOWHTO allows preservation of posterior tibial slope while correcting the varus knee adequately.展开更多
Main intention of the research is to understand about significance of techniques associated with HTO. This research reviewed the techniques of high tibial osteotomy namely high tibial osteotomy, open wedge high tibial...Main intention of the research is to understand about significance of techniques associated with HTO. This research reviewed the techniques of high tibial osteotomy namely high tibial osteotomy, open wedge high tibial osteotomy, closedhigh tibial osteotomy. Patients who are suffering from knee arthritis, high tibial osteotomy assists to prevent or delay the requirement for total or partial replacement of knee to preserve damaged tissue of joint. High tibial osteotomy technique is mainly suitable for active and young patients with knee osteoarthritis. Age plays a main factor in success rate of high tibial osteotomy technique. It could be done in open wedge or closed wedge high tibial osteotomy. For some cases, surgery could be done in combined method (open wedge and closed wedge high tibial osteotomy). When compared with clinical outcomes of closed wedge high tibial osteotomy and open wedge high tibial osteotomy, open wedge high tibial osteotomy performs well in reducing the pain, duration of weight-bearing and return to normal life as soon as possible.展开更多
目的在膝内侧间室骨关节炎临床治疗过程中采取两种截骨术(腓骨截骨、内侧开放性楔形胫骨高位截骨),研究比较其临床治疗。方法选取2021年1月—2022年1月南通市第二人民医院所治疗的40例膝内侧间室骨关节炎患者,根据手术治疗方案将其均分...目的在膝内侧间室骨关节炎临床治疗过程中采取两种截骨术(腓骨截骨、内侧开放性楔形胫骨高位截骨),研究比较其临床治疗。方法选取2021年1月—2022年1月南通市第二人民医院所治疗的40例膝内侧间室骨关节炎患者,根据手术治疗方案将其均分为对照组(采取腓骨截骨术进行治疗,20例)与观察组(采取内侧开放性楔形胫骨高位截骨进行治疗,20例),研究观察两种截骨术的临床疗效。结果与对照组相比,观察组失血量较多[(327.62±115.84)mL vs(251.28±84.44)mL],差异有统计学意义(t=2.382,P<0.05);观察组血红蛋白变化量较多,差异有统计学意义(P<0.05);观察组术后16 h的视觉模拟评估量表(Visual Analogue Scale,VAS)分数较低[(1.32±0.57)分vs(1.86±0.97)分],差异有统计学意义(t=2.147,P<0.05);同时较之治疗前,两组患者治疗后膝关节功能(Hospital for special surgery,HSS)分数与骨性关节炎(Weern Otario and Mcmaster Universities Osteoarthritis,WOMAC)分数均更高,差异有统计学意义(P<0.05)。两组手术治疗时间、止血带使用时间、术后8 h与24 h的VAS分数、治疗前后HSS分数与WOMAC分数比较,差异无统计学意义(P>0.05)。结论与腓骨截骨术相比,内侧开放性楔形胫骨高位截骨治疗膝内侧室骨关节炎效果更佳。内侧开放性楔形胫骨高位截骨能够减轻术后疼痛感,值得推荐。展开更多
文摘Background: Biplanar medial opening wedge high tibial osteotomy (MOWHTO) is a treatment method that allows adequate correction of symptomatic varus knee deformity. However, MOWHTO tends to decrease patellar height and increase the posterior tibial slope, which can affect the knee joint stability. Objective: The aim of this study was to describe the technique of biplanar MOWHTO and fixation by TomoFix plate, as well as to evaluate the accuracy of the planned correction and the postoperative tibial slope. Patients and Methods: This prospective cohort study was conducted on patients who presented with varus knee deformity and underwent biplanar MOWHTO and fixation by TomoFix plate during the period from March 2016 to March 2017. Assessment of patients included pre- and postoperative Knee and function scores, mechanical femorotibial angle (mFTA), posterior tibial slope angle (pTSA), range of motion (ROM) and radiological evaluation of the healing of the osteotomy site. Results: The recruited patients were 13 (8 men and 5 women), with average age 31.7 years old. The knee and functional scores improved from the preoperative mean of 45 and 41 to the postoperative mean of 85 and 72 points, respectively. The average knee flexion was 115 degrees, which at the final follow-up remained unchanged except for one case. The mean preoperative mFTA was 13.5°varus and decreased post-operatively to a mean of 3°valgus. The average postoperative follow-up period was 12 months (10 - 18 M). Conclusion: The biplanar MOWHTO allows preservation of posterior tibial slope while correcting the varus knee adequately.
文摘Main intention of the research is to understand about significance of techniques associated with HTO. This research reviewed the techniques of high tibial osteotomy namely high tibial osteotomy, open wedge high tibial osteotomy, closedhigh tibial osteotomy. Patients who are suffering from knee arthritis, high tibial osteotomy assists to prevent or delay the requirement for total or partial replacement of knee to preserve damaged tissue of joint. High tibial osteotomy technique is mainly suitable for active and young patients with knee osteoarthritis. Age plays a main factor in success rate of high tibial osteotomy technique. It could be done in open wedge or closed wedge high tibial osteotomy. For some cases, surgery could be done in combined method (open wedge and closed wedge high tibial osteotomy). When compared with clinical outcomes of closed wedge high tibial osteotomy and open wedge high tibial osteotomy, open wedge high tibial osteotomy performs well in reducing the pain, duration of weight-bearing and return to normal life as soon as possible.
文摘目的在膝内侧间室骨关节炎临床治疗过程中采取两种截骨术(腓骨截骨、内侧开放性楔形胫骨高位截骨),研究比较其临床治疗。方法选取2021年1月—2022年1月南通市第二人民医院所治疗的40例膝内侧间室骨关节炎患者,根据手术治疗方案将其均分为对照组(采取腓骨截骨术进行治疗,20例)与观察组(采取内侧开放性楔形胫骨高位截骨进行治疗,20例),研究观察两种截骨术的临床疗效。结果与对照组相比,观察组失血量较多[(327.62±115.84)mL vs(251.28±84.44)mL],差异有统计学意义(t=2.382,P<0.05);观察组血红蛋白变化量较多,差异有统计学意义(P<0.05);观察组术后16 h的视觉模拟评估量表(Visual Analogue Scale,VAS)分数较低[(1.32±0.57)分vs(1.86±0.97)分],差异有统计学意义(t=2.147,P<0.05);同时较之治疗前,两组患者治疗后膝关节功能(Hospital for special surgery,HSS)分数与骨性关节炎(Weern Otario and Mcmaster Universities Osteoarthritis,WOMAC)分数均更高,差异有统计学意义(P<0.05)。两组手术治疗时间、止血带使用时间、术后8 h与24 h的VAS分数、治疗前后HSS分数与WOMAC分数比较,差异无统计学意义(P>0.05)。结论与腓骨截骨术相比,内侧开放性楔形胫骨高位截骨治疗膝内侧室骨关节炎效果更佳。内侧开放性楔形胫骨高位截骨能够减轻术后疼痛感,值得推荐。
