| 祁师亮,韩乐奇,杨开祥.膝关节线倾斜度对开放楔形胫骨高位截骨术早期预后的影响.骨科,2025,16(4): 308-314. |
| 膝关节线倾斜度对开放楔形胫骨高位截骨术早期预后的影响 |
| Effect of knee joint line obliquity on early prognosis of open wedge high tibial osteotomy |
| 投稿时间：2024-05-27 |
| DOI：DOI：10.3969/j.issn.1674-8573.2025.04.004 |
| 中文关键词: 膝 胫骨 骨关节炎 截骨术 临床疗效 |
| 英文关键词: Knee Tibia Osteoarthritis Osteotomy Clinical effect |
| 基金项目:武汉市科技局知识创新专项基础研究项目（2022020801010557）；武汉市卫健委青年人才项目（WX20Q06）；湖北省自然科学基金面上项目（2021CFB529） |
|
| 摘要点击次数: 24 |
| 全文下载次数: 10 |
| 中文摘要: |
| 目的 探讨膝关节线倾斜度（joint line obliquity，JLO）对开放楔形胫骨高位截骨术（open wedge high tibial osteotomy，OWHTO）术后下肢力线和临床疗效的影响。方法 回顾性分析2021年6月至2022年4月在武汉市第四医院骨关节科接受OWHTO手术治疗的84例KOA病人。根据术后胫骨机械轴近端内侧角（mechanical medial proximal tibia angle，mMPTA）和Mikulicz关节线角（Mikulicz joint line angle，MJLA），将病人分为正常组和异常组。通过对比术前及术后2年的影像学结果、疼痛视觉模拟量表（visual analogue scale，VAS）评分、美国膝关节学会评分（American Knee Society Score，AKSS）、西安大略和麦克马斯特大学（Western Ontario and McMaster Universities，WOMAC）骨关节炎指数和膝关节活动度（range of motion，ROM），评估JLO对临床结果的影响。结果 在84例病人中，MJLA异常组OWHTO术后2年的mMPTA（93.76°±1.27°vs. 92.76°±1.36°）及其变化值（9.65°±2.07° vs. 5.81°±3.13°）、负重力线比值（weight bearing line ratio，WBLR）（64.59%±3.64% vs. 61.58%±4.32%）、VAS评分［（3.88±0.73）分 vs. （3.53±0.68）分］均显著高于正常组，AKSS评分［（72.16±5.39）分 vs. （75.34±5.95）分］显著低于正常组，差异有统计学意义（P＜0.05）。mMPTA异常组OWHTO术后2年的MJLA（95.95°±2.39° vs. 92.42°±2.80°）及其变化值（6.19°±2.99° vs. 3.74°±2.68°）、WBLR（66.89%±2.55% vs. 61.88%±4.19%）均显著高于正常组，差异有统计学意义（P＜0.05）。结论 OWHTO术后JLO（MJLA、mMPTA）过大可能导致关节内部结构受力不均，加剧关节软骨或半月板的退变，对下肢力线和临床疗效产生负面影响。 |
| 英文摘要: |
| Objective To investigate the impact of joint line obliquity (JLO) on postoperative lower limb alignment and clinical outcomes after open wedge high tibial osteotomy (OWHTO). Methods Totally, 84 patients with knee osteoarthritis (KOA) who underwent OWHTO surgery from June 2021 to April 2022 at the Department of Bone and Joint, Wuhan No. 4 Hospital, were retrospectively analyzed. Patients were divided into normal and abnormal groups based on postoperative mechanical medial proximal tibial angle (mMPTA) and Mikulicz joint line angle (MJLA). The preoperative and 2-year postoperative imaging results, visual analogue scale (VAS) for pain, American Knee Society Score (AKSS), Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index, and range of motion (ROM) were compared to assess the impact of JLO on clinical outcomes. Results Among the 84 patients, those in the abnormal MJLA group had significantly higher values at 2 years postoperatively than the normal group in terms of mMPTA (93.76°±1.27° vs. 92.76°±1.36°), change in mMPTA (9.65°±2.07° vs. 5.81°±3.13°), weight bearing line ratio (WBLR) (64.59%±3.64%vs. 61.58%±4.32%), and VAS score (3.88±0.73 vs. 3.53±0.68), but the AKSS (72.16±5.39 vs. 75.34±5.95) was significantly lower (P＜0.05). Similarly, patients in the abnormal mMPTA group demonstrated significantly greater values at 2 years postoperatively in MJLA (95.95°±2.39° vs. 92.42°±2.80°), change in MJLA (6.19°±2.99° vs. 3.74°±2.68°), WBLR (66.89%±2.55% vs. 61.88%±4.19%) (P＜0.05). Conclusion Excessive knee joint line obliquity (MJLA or mMPTA) after OWHTO can lead to uneven stress on internal joint structures, exacerbating the degeneration of articular cartilage or meniscus, which may negatively impact lower limb coronal alignment and clinical outcomes. |
|
查看全文
下载PDF阅读器 |
| 关闭 |
