Objective: To explore the short-term effectiveness of medial open wedge high tibial osteotomy (OWHTO) combined with posterior slope angle of tibial plateau correction to treat the osteoarthritis of limited flexion knee with varus deformity.
Methods: The data of 18 cases (18 knee) with osteoarthritis of limited flexion knee with varus deformity between January 2014 and July 2016 were analyzed retrospectively. There were 6 males and 12 females with an average age of 54.9 years (range, 48-64 years). There were 8 cases of left knee and 10 cases of right knee. The varus of knee ranged from 7.45 to 15.52° (mean, 10.63°). According to Kellgren-Lawrence grading standard, there were 4 cases of grade Ⅱ and 14 of grade Ⅲ. OWHTO was used to adjust the varus deformity, and the posterior slope angle of tibial plateau was adjusted to solve the limited flexion.
Results: The thickness of osteotomy was 10-19 mm (mean, 14.91 mm). The operation time was 1.2-2.0 hours (mean, 1.4 hours). All incisions healed by first intension. All patients were followed up 1.0-2.5 years, with an average of 1.5 years. At last follow-up, the range of knee flexion and Lysholm score, Hospital for Special Surgery (HSS) score, and International Knee Documentation Committee (IKDC) score were significantly higher than preoperative ones, showing significant differences ( P<0.05). X-ray films showed that the osteotomy healed at 3- 7 months (mean, 3.6 months) after operation. At last follow-up, the limb alignment by the relative position of tibial plateau and the posterior slope angle of tibial plateau were significantly improved, showing significant differences when compared with preoperative ones ( P<0.05).
Conclusion: The OWHTO combined with posterior slope angle of tibial plateau correction can significantly improve the range of flexion and functional score in short-term.
目的: 探讨内侧撑开高位胫骨截骨术联合调整胫骨平台后倾角治疗屈曲受限型膝内翻骨关节炎的早期疗效。.
方法: 回顾性分析 2014 年 1 月—2016 年 7 月收治并符合选择标准的 18 例（18 膝）屈曲受限型膝内翻骨关节炎患者临床资料。其中，男 6 例，女 12 例；年龄 48～64 岁，平均 54.9 岁。左膝 8 例，右膝 10 例。膝内翻 7.45～15.52°，平均 10.63°。按照 Kellgren-Lawrence 分级标准：Ⅱ级 4 例，Ⅲ级 14 例。术中采用内侧撑开高位胫骨截骨矫正膝内翻，同时调整胫骨平台后倾角以改善屈曲受限。.
结果: 术中截骨厚度为 10～19 mm，平均 14.91 mm；手术时间 1.2～2.0 h，平均 1.4 h。术后切口均Ⅰ期愈合。患者均获随访，随访时间 l.0～2.5 年，平均 1.5 年。末次随访时，患者膝关节屈曲角度较术前增加，Lysholm 评分、美国特种外科医院（HSS）评分、国际膝关节文献委员会（IKDC）评分均较术前明显提高，比较差异有统计学意义（ P<0.05）。X 线片复查示，截骨均愈合，愈合时间 3～7 个月，平均 3.6 个月。末次随访时，下肢力线通过胫骨平台相对位置以及胫骨平台后倾角均较术前明显改善，比较差异有统计学意义（ P<0.05）。.
结论: 内侧撑开高位胫骨截骨术联合调整胫骨平台后倾角治疗屈曲受限型膝内翻骨关节炎，可有效改善膝关节屈曲角度，获得良好早期疗效。.
Keywords: Knee; Osteoarthritis; Varus of knee; high tibial osteotomy; posterior tibial slope.