Effectiveness of double-plane high tibial osteotomy in treatment of medial compartment osteoarthritis_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WEI Wei ,  SHEN Jirong

Nanjing University of Chinese Medicine, Nanjing Jiangsu, 210023, P.R.China;

Corresponding?author：

SHEN Jirong, Email: shenjirongjoint@126.com

Keywords：

Double-plane high tibial osteotomy; medial compartment osteoarthritis; knee

DOI：

10.7507/1002-1892.201805037

Video：

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Objective To investigate the effectiveness of double-plane high tibial osteotomy in treatment of medial compartment osteoarthritis. Methods The clinical data of 65 patients with medial compartment osteoarthritis who were treated with double-plane high tibial osteotomy between January 2014 and January 2017 was retrospectively analyzed. There were 28 males and 37 females. The age ranged from 46 to 75 years with an average of 53.2 years. There were 30 cases in the left knee and 35 cases in the right knee. The disease duration was 3-7 years (mean, 4.0 years). The patients had different degrees of pain in the knee joint and difficulty walking. The knee joint compression test was positive. The knee joint function was evaluated by Hospital for Special Surgery (HSS) score and knee society score (KSS) clinical and functional scores. The visual analogue scale (VAS) score was adopted to pain measurement. The healing of osteotomy was observed by X-ray films during follow-up; the femur tibia angle (FTA), posterior tibial slope (PTS), medial proximal tibial angle (MPTA), and knee varus angle (KVA) were also calculated. Results All the incisions healed by first intention after operation. Only 1 case had numbness of the toe, and the symptoms disappeared after symptomatic treatment. All patients were followed up 13-18 months with an average of 15.4 months. X-ray examination showed that all patients had bone healing at 12 weeks after operation. There were significant differences in MPTA, FTA, PTS, and KVA between pre- and post-operation (P<0.05). There was no significant difference in above parameters among 1 week, 6 months, and 12 months after operation (P>0.05). There was no loosening and rupture of the fixator during the follow-up. The HSS score and KSS clinical and functional scores at 12 months after operation were significantly higher than those before operation (P<0.05). The VAS scores at 1 week, 6 months, and 12 months after operation were significantly lower than that before operation (P<0.05). Conclusion Double-plane high tibial osteotomy for medial compartment osteoarthritis can effectively relieve pain symptoms and improve joint function.

Citation： WEI Wei, SHEN Jirong. Effectiveness of double-plane high tibial osteotomy in treatment of medial compartment osteoarthritis. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(11): 1406-1410. doi: 10.7507/1002-1892.201805037 Copy

1.	張英澤, 李存樣, 李冀東, 等. 不均勻沉降在膝關節退變及內翻過程中機制的研究. 河北醫科大學學報, 2014, 35(2): 218-219.
2.	Webb M, Dewan V, Elson D. Functional results following high tibial osteotomy: a review of the literature. Eur J Orthop Surg Traumatol, 2018, 28(4): 555-563.
3.	van Egmond N, Janssen D, Hannink G, et al. Biomechanical comparison of two different locking plates for open wedge high tibial osteotomy. J Orthop Sci, 2018, 23(1): 105-111.
4.	陳偉, 陳百成, 王飛, 等. 應用不同方法治療膝關節骨性關節炎的對比研究. 河北醫科大學學報, 2015, 36(5): 600-602.
5.	Torres-Claramunt R, Pelfort X, Hinarejos P, et al. Pressure algometry is an excellent tool to measure knee pain relief after a closing-wedge high tibial osteotomy. Orthop Traumatol Surg Res, 2018, 104(2): 193-196.
6.	Wu L, Lin J, Jin Z, et al. Comparison of clinical and radiological outcomes between opening-wedge and closing-wedge high tibial osteotomy: A comprehensive meta-analysis. PLoS One, 2017, 12(2): e0171700.
7.	張子琦, 梁佳林, 樊立宏, 等. 開放楔形脛骨高位截骨術治療膝關節內側間室骨關節炎療效觀察. 中國修復重建外科雜志, 2018, 32(8): 997-1000.
8.	Sundararajan SR, Nagaraja HS, Rajasekaran S. Medial open wedge high tibial osteotomy for varus malunited tibial plateau fractures. Arthroscopy, 2017, 33(3): 586-594.
9.	熊福軍, 賀西京, 馮宏偉, 等. 關節鏡下脛骨高位截骨治療早期膝骨關節炎并內翻畸形療效觀察. 現代中西醫結合雜志, 2014, 23(4): 389-390.
10.	陳國仙, 李國山, 林宗錦, 等. 3-D打印技術輔助脛骨高位截骨術治療膝內翻畸形骨關節炎的療效觀察. 中國修復重建外科雜志, 2016, 30(4): 407-411.
11.	張子琦, 王春生, 楊佩, 等. 直接前入路與后入路對人工全髖關節置換術后早期康復的影響比較. 中國修復重建外科雜志, 2018, 32(3): 329-333.
12.	Stannard JT, Stannard JP. High tibial osteotomy following biologic replacement of the knee. J Knee Surg, 2017, 30(8): 764-768.
13.	裴保安, 吳立生, 張存華. 脛骨高位截骨術治療膝關節內側間室骨關節炎并內翻畸形一例. 中華關節外科雜志(電子版), 2016, 10(5): 577-579.
14.	Shin YS, Sim HB, Yoon JR. Tibial nerve neuropathy following medial opening-wedge high tibial osteotomy-case report of a rare technical complication. Eur J Orthop Surg Traumatol, 2017, 27(4): 563-567.
15.	Aglietti P, Buzzi R, Vena LM, et al. High tibial valgus osteotomy for medial gonarthrosis: a 10- to 21-year study. J Knee Surg, 2003, 16(1): 21-26.
16.	包學智, 趙蓬, 劉培來, 等. 脛骨內側開放楔形高位截骨治療膝關節內側間室骨關節炎的短期療效. 山東大學學報(醫學版), 2016, 54(10): 85-89.
17.	趙允, 胡文晉, 黃競敏, 等. 內側撐開高位脛骨截骨術聯合調整脛骨平臺后傾角治療屈曲受限型膝內翻骨關節炎的早期療效. 中國修復重建外科雜志, 2018, 32(2): 157-161.
18.	Hernigou P, Roussignol X, Flouzat-Lachaniette CH, et al. Opening wedge tibial osteotomy for large varus deformity with Ceraver resorbable beta tricalcium phosphate wedges. Int Orthop, 2009, 34(2): 191-199.
19.	Tabrizi A, Soleimanpour J, Sadighi A, et al. A short term follow up comparison of genu varum corrective surgery using open and closed wedge high tibial osteotomy. Malays Orthop J, 2013, 7(1): 7-12.
20.	張德新, 陳德生, 馬麗艷, 等. 關節鏡探查清理+內側開放撐開式脛骨高位截骨治療膝關節內側單間室骨性關節炎. 中國煤炭工業醫學雜志, 2016, 19(8): 1161-1164.

1. 張英澤, 李存樣, 李冀東, 等. 不均勻沉降在膝關節退變及內翻過程中機制的研究. 河北醫科大學學報, 2014, 35(2): 218-219.
2. Webb M, Dewan V, Elson D. Functional results following high tibial osteotomy: a review of the literature. Eur J Orthop Surg Traumatol, 2018, 28(4): 555-563.
3. van Egmond N, Janssen D, Hannink G, et al. Biomechanical comparison of two different locking plates for open wedge high tibial osteotomy. J Orthop Sci, 2018, 23(1): 105-111.
4. 陳偉, 陳百成, 王飛, 等. 應用不同方法治療膝關節骨性關節炎的對比研究. 河北醫科大學學報, 2015, 36(5): 600-602.
5. Torres-Claramunt R, Pelfort X, Hinarejos P, et al. Pressure algometry is an excellent tool to measure knee pain relief after a closing-wedge high tibial osteotomy. Orthop Traumatol Surg Res, 2018, 104(2): 193-196.
6. Wu L, Lin J, Jin Z, et al. Comparison of clinical and radiological outcomes between opening-wedge and closing-wedge high tibial osteotomy: A comprehensive meta-analysis. PLoS One, 2017, 12(2): e0171700.
7. 張子琦, 梁佳林, 樊立宏, 等. 開放楔形脛骨高位截骨術治療膝關節內側間室骨關節炎療效觀察. 中國修復重建外科雜志, 2018, 32(8): 997-1000.
8. Sundararajan SR, Nagaraja HS, Rajasekaran S. Medial open wedge high tibial osteotomy for varus malunited tibial plateau fractures. Arthroscopy, 2017, 33(3): 586-594.
9. 熊福軍, 賀西京, 馮宏偉, 等. 關節鏡下脛骨高位截骨治療早期膝骨關節炎并內翻畸形療效觀察. 現代中西醫結合雜志, 2014, 23(4): 389-390.
10. 陳國仙, 李國山, 林宗錦, 等. 3-D打印技術輔助脛骨高位截骨術治療膝內翻畸形骨關節炎的療效觀察. 中國修復重建外科雜志, 2016, 30(4): 407-411.
11. 張子琦, 王春生, 楊佩, 等. 直接前入路與后入路對人工全髖關節置換術后早期康復的影響比較. 中國修復重建外科雜志, 2018, 32(3): 329-333.
12. Stannard JT, Stannard JP. High tibial osteotomy following biologic replacement of the knee. J Knee Surg, 2017, 30(8): 764-768.
13. 裴保安, 吳立生, 張存華. 脛骨高位截骨術治療膝關節內側間室骨關節炎并內翻畸形一例. 中華關節外科雜志(電子版), 2016, 10(5): 577-579.
14. Shin YS, Sim HB, Yoon JR. Tibial nerve neuropathy following medial opening-wedge high tibial osteotomy-case report of a rare technical complication. Eur J Orthop Surg Traumatol, 2017, 27(4): 563-567.
15. Aglietti P, Buzzi R, Vena LM, et al. High tibial valgus osteotomy for medial gonarthrosis: a 10- to 21-year study. J Knee Surg, 2003, 16(1): 21-26.
16. 包學智, 趙蓬, 劉培來, 等. 脛骨內側開放楔形高位截骨治療膝關節內側間室骨關節炎的短期療效. 山東大學學報(醫學版), 2016, 54(10): 85-89.
17. 趙允, 胡文晉, 黃競敏, 等. 內側撐開高位脛骨截骨術聯合調整脛骨平臺后傾角治療屈曲受限型膝內翻骨關節炎的早期療效. 中國修復重建外科雜志, 2018, 32(2): 157-161.
18. Hernigou P, Roussignol X, Flouzat-Lachaniette CH, et al. Opening wedge tibial osteotomy for large varus deformity with Ceraver resorbable beta tricalcium phosphate wedges. Int Orthop, 2009, 34(2): 191-199.
19. Tabrizi A, Soleimanpour J, Sadighi A, et al. A short term follow up comparison of genu varum corrective surgery using open and closed wedge high tibial osteotomy. Malays Orthop J, 2013, 7(1): 7-12.
20. 張德新, 陳德生, 馬麗艷, 等. 關節鏡探查清理+內側開放撐開式脛骨高位截骨治療膝關節內側單間室骨性關節炎. 中國煤炭工業醫學雜志, 2016, 19(8): 1161-1164.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness of double-plane high tibial osteotomy in treatment of medial compartment osteoarthritis

Abstract Full text Figures/Tables Video References Cited by

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