Open Wedge High Tibial Osteotomy and Combined Arthroscopic Surgery in Severe Medial Osteoarthritis and Varus Malalignment: Minimum 5-Year Results
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
purpose: To evaluate the radiologic and functional outcomes of medial open wedge high tibial osteotomy (HTO) combined with arthroscopic procedure in patients with medial osteoarthritis. Materials and Methods: From June 1996 to March 2010, 26 patients (32 knees) who underwent medial open wedge osteotomy and arthroscopic operation for medial osteoarthritis were retrospectively reviewed. Measurements included hip-knee-ankle (HKA) angle, femorotibial angle, medial proximal tibial angle, posterior tibial slope angle, and Kellgren-Lawrence grade. Clinical evaluation was performed using Lysholm knee scoring scale and knee and function score of the American Knee Society.results: Differences between the mean preoperative and postoperative measurements were significant in all angles including the HKA angle (–5.7o and +5.5o), femorotibial angle (–1.9o and +9.8o), and medial proximal tibial angle (82.9o and 90.5o) (p<0.05). Mean Lysholm knee scoring scale was 63.6 preoperatively and 88.7 at the last follow-up, mean Knee Society knee score was 61.2 and 86.6, and mean function score was 59.3 and 87.2, respectively. All differences were significant (p<0.05).conclusions: Medial open wedge HTO in combination with arthroscopic procedure is an effective treatment method for medial osteoarthritis to treat varus deformity and an intra-articular lesion.
Abstract
purpose: To evaluate the radiologic and functional outcomes of medial open wedge high tibial osteotomy (HTO) combined with arthroscopic procedure in patients with medial osteoarthritis. Materials and Methods: From June 1996 to March 2010, 26 patients (32 knees) who underwent medial open wedge osteotomy and arthroscopic operation for medial osteoarthritis were retrospectively reviewed. Measurements included hip-knee-ankle (HKA) angle, femorotibial angle, medial proximal tibial angle, posterior tibial slope angle, and Kellgren-Lawrence grade. Clinical evaluation was performed using Lysholm knee scoring scale and knee and function score of the American Knee Society.results: Differences between the mean preoperative and postoperative measurements were significant in all angles including the HKA angle (–5.7o and +5.5o), femorotibial angle (–1.9o and +9.8o), and medial proximal tibial angle (82.9o and 90.5o) (p<0.05). Mean Lysholm knee scoring scale was 63.6 preoperatively and 88.7 at the last follow-up, mean Knee Society knee score was 61.2 and 86.6, and mean function score was 59.3 and 87.2, respectively. All differences were significant (p<0.05).conclusions: Medial open wedge HTO in combination with arthroscopic procedure is an effective treatment method for medial osteoarthritis to treat varus deformity and an intra-articular lesion.
참고문헌 (30)
- Iorio R, "Orthopaedic surgeon workforce and volume assessment for total hip and knee replacement in the United States : preparing for an epidemic", J Bone Joint Surg Am, 90, pp.1598~1605 (2008)
- Krych AJ, "Does arthroscopic knee surgery work?", Arthroscopy, 30, pp.544~545 (2014)
- Marmor L., "Unicompartmental and total knee arthroplasty", Clin Orthop Relat Res, (192), pp.75~81 (1985)
- Jackson JP, "Tibial osteotomy for osteoarthritis of the knee", Proc R Soc Med, 53, pp.888~ (1960)
- Coventry MB, "osteotomy of the upper portion of the tibia for degenerative arthritis of the knee : a preliminary report", J Bone Joint Surg Am, 47, pp.984~990 (1965)
- Cho WS, "Valgus high tibial osteotomy for osteoarthritis of the knee", J Korean Orthop Assoc, 30, pp.1624~1630 (1995)
- W-Dahl A, "High tibial osteotomy in Sweden, 1998-2007 : a population-based study of the use and rate of revision to knee arthroplasty", Acta Orthop, 83, pp.244~248 (2012)
- Kim BJ, "High tibial osteotomy", J Korean Orthop Assoc, 29, pp.627~633 (1994)
- Kellgren JH, "Radiological assessment of osteoarthrosis", Ann Rheum Dis, 16, pp.494~502 (1957)
- Han SB, "A"safe zone"in medial open-wedge high tibia osteotomy to prevent lateral cortex fracture", Knee Surg Sports Traumatol Arthrosc, 21, pp.90~95 (2013)
- Fujisawa Y, "The effect of high tibial osteotomy on osteoarthritis of the knee : an arthroscopic study of 54 knee joints", Orthop Clin North Am, 10, pp.585~608 (1979)
- Schuster P, "Open-wedge high tibial osteotomy and combined abrasion", microfracture in severe medial osteoarthritis and varus malalignment : 5-year results and arthroscopic findings after 2 years, 2015, pp.31, 1279~1288
- Moreland JR, "Radiographic analysis of the axial alignment of the lower extremity", J Bone Joint Surg Am, 69, pp.745~749 (1987)
- Bauer GC, "Tibial osteotomy in gonarthrosis(osteo-arthritis of the knee)", J Bone Joint Surg Am, 51, pp.1545~1563 (1969)
- Pandit H, "The Oxford medial unicompartmental knee replacement using a minimally-invasive approach", J Bone Joint Surg Br, 88, pp.54~60 (2006)
- Brandon ML, "The association between posterior-inferior tibial slope and anterior cruciate ligament insufficiency", Arthroscopy, 22, pp.894~899 (2006)
- Tegner Y, "Rating systems in the evaluation of knee ligament injuries", Clin Orthop Relat Res, 198, pp.43~49 (1985)
- Lasam MP, "Femoral lateral bowing and varus condylar orientation are prevalent and affect axial alignment of TKA in Koreans", Clin Orthop Relat Res, 471, pp.1472~1483 (2013)
- Kim HA, "The epidemiology of total knee replacement in South Korea : national registry data", Rheumatology(Oxford), 47, pp.88~91 (2008)
- Koh IJ, "Trends in high tibial osteotomy and knee arthroplasty utilizations and demographics in Korea from 2009 to 2013", J Arthroplasty, 30, pp.939~944 (2015)
- Spahn G, "The impact of a high tibial valgus osteotomy and unicondylar medial arthroplasty on the treatment for knee osteoarthritis : a meta-analysis", Knee Surg Sports Traumatol Arthrosc, 21, pp.96~112 (2013)
- Floerkemeier S, "Outcome after high tibial open-wedge osteotomy : a retrospective evaluation of 533 patients", Knee Surg Sports Traumatol Arthrosc, 21, pp.170~180 (2013)
- Pascale W, "Do microfractures improve high tibial osteotomy outcome?", Orthopedics, 34, pp.e251~e255 (2011)
- Jung WH, "Comparison of results of medial opening-wedge high tibial osteotomy with and without subchondral drilling", Arthroscopy, 31, pp.673~679 (2015)
- Matsunaga D, "Repair of articular cartilage and clinical outcome after osteotomy with microfracture or abrasion arthroplasty for medial gonarthrosis", Knee, 14, pp.465~471 (2007)
- Harris JD, "Survival and clinical outcome of isolated high tibial osteotomy and combined biological knee reconstruction", Knee, 20, pp.154~161 (2013)
- Sterett WI, "Chondral resurfacing and high tibial osteotomy in the varus knee : survivorship analysis", Am J Sports Med, 38, pp.1420~1424 (2010)
- Hernigou P, "Opening wedge tibial osteotomy for large varus deformity with Ceraver resorbable beta tricalcium phosphate wedges", Int Orthop, 34, pp.191~199 (2010)
- Laprade RF, "Prospective outcomes of young and middle-aged adults with medial compartment osteoarthritis treated with a proximal tibial opening wedge osteotomy", Arthroscopy, 28, pp.354~364 (2012)
- Bode G, "Prospective 5-year survival rate data following open-wedge valgus high tibial osteotomy", Knee Surg Sports Traumatol Arthrosc, 23, pp.1949~1955 (2015)