Clinical application of Taylor spatial frame in adjustment of lower extremity force line of knee medial compartmental osteoarthritis_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHANG Weiye ¹ ,  WAN Chunyou ² , ZHANG Tao ² , WANG Mingjie ² , LIU Zhao ² , ZHAO Yuanhang ¹

1. Graduate School of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, P.R.China;
2. Department of Limb Orthopaedics, Tianjin Hospital, Tianjin, 300211, P.R.China;

Corresponding?author：

WAN Chunyou, Email: wanchunyouxs@163.com

Keywords：

Taylor spatial frame; locking steel plate; knee osteoarthritis; lower extremity force line

DOI：

10.7507/1002-1892.201905106

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the safety and effectiveness of Taylor spatial frame (TSF) in the treatment of medial compartmental osteoarthritis (MCOA) of the knee and the adjustment of the lower extremity force line at the same time.Methods The clinical data of 30 patients with MCOA who underwent high tibial osteotomy (HTO) between October 2016 and April 2017 were retrospectively analyzed. According to the different fixation methods, they were divided into external fixation group (TSF external fixation, 16 cases) and internal fixation group (locking steel plate internal fixation, 14 cases). There was no significant difference between the two groups in gender, age, side, disease duration, mechanical femur tibia angle (MFTA), and other general data (P>0.05). The operation time and intraoperative blood loss of the two groups were recorded and compared; MFTA was used to evaluate the recovery of the lower extremity force line at last follow-up; Hospital for Special Surgery (HSS) score was used to evaluate the clinical effecacy before operation and at 2 weeks, 1 month, and 3 months after operation.Results The operation time and intraoperative blood loss of external fixation group were significantly less than those of internal fixation group (P<0.05). All patients were followed up 9-16 months, with an average of 12 months. There were 2 cases of delayed healing in the internal fixation group and 1 case of delayed healing in the external fixation group, and all healed after symptomatic treatment. All patients in the two groups had no complication such as needle infection, nonunion at osteotomy, osteomyelitis, and so on. At last follow-up, MFTA standard was used to evaluate the recovery of force line. The results of external fixation group were all excellent, while the results of internal fixation group were excellent in 10 cases and good in 4 cases. The difference between the two groups was significant (Z=–2.258, P=0.024). The HSS scores in the two groups were significantly improved at each time point after operation, and gradually improved with time after operation (P<0.05). The HSS score of the external fixation group was significantly higher than that of the internal fixation group (t=2.425, P=0.022) at 3 months after operation; and there was no significant difference between the two groups at other time points (P>0.05).Conclusion TSF has unique advantages in HTO treatment of MCOA patients and correction of lower extremity force line, such as shorter operation time, less bleeding, firm fixation, and less complications. It can accurately adjust the lower extremity force line after operation and has good effectiveness. It is an effective and safe fixation method.

Citation： ZHANG Weiye, WAN Chunyou, ZHANG Tao, WANG Mingjie, LIU Zhao, ZHAO Yuanhang. Clinical application of Taylor spatial frame in adjustment of lower extremity force line of knee medial compartmental osteoarthritis. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(4): 452-456. doi: 10.7507/1002-1892.201905106 Copy

1.	Ivarsson I, Myrnerts R, Gillquist J. High tibial osteotomy for medial osteoarthritis of the knee. A 5 to 7 and 11 year follow-up. J Bone Joint Surg (Br), 1990, 72(2): 238-244.
2.	Hernigou P, Medevielle D, Debeyre J, et al. Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study. J Bone Joint Surg (Am), 1987, 69(3): 332-354.
3.	Kim HJ, Park J, Shin JY, et al. More accurate correction can be obtained using a three-dimensional printed model in open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc, 2018, 26(11): 3452-3458.
4.	Altman R, Asch E, Bloch D, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum, 1986, 29(8): 1039-1049.
5.	Tseng TH, Tsai YC, Lin KY, et al. The correlation of sagittal osteotomy inclination and the anteroposterior translation in medial open-wedge high tibial osteotomy-one of the causes affecting the patellofemoral joint? Int Orthop, 2019, 43(3): 605-610.
6.	Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis, 1957, 16(4): 494-502.
7.	孔偉, 黃慶紅. 雙下肢站立位 DR 全長攝影在骨科矯形中的臨床價值. 中國醫藥科學, 2017, 7(3): 137-141.
8.	馬繼海, 張濤, 海碧霞, 等. 骨外固定動力化治療開放性脛腓骨骨折. 中國修復重建外科雜志, 2018, 32(2): 174-177.
9.	雍煒, 曹海鯤, 趙遠航, 等. Taylor 空間支架在脛腓骨骨折下肢力線調整中的臨床應用. 世界最新醫學信息文摘, 2018, 18(105): 31-33.
10.	Lawrence RC, Felson DT, Helmick CG, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part Ⅱ. Arthritis Rheum, 2008, 58(1): 26-35.
11.	Lespasio MJ, Piuzzi NS, Husni ME, et al. Knee osteoarthritis: A primer. Perm J, 2017, 21: 16-183.
12.	任燕, 石婭婭, 譚波, 等. 中國人群膝骨關節炎危險因素的 Meta 分析. 現代預防醫學, 2015, 42(12): 2282-2284, 2292.
13.	陳蕾, 李江偉, 鄭明. 腓骨高位截骨對膝關節應力改變的三維有限元分析. 中國骨與關節損傷雜志, 2018, 33(6): 583-585.
14.	張英澤, 李存祥, 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.
15.	Bonasia DE, Dettoni F, Sito G, et al. Medial opening wedge high tibial osteotomy for medial compartment overload/arthritis in the varus knee: prognostic factors. Am J Sports Med, 2014, 42(3): 690-698.
16.	Warden SJ, Morris HG, Crossley KM, et al. Delayed-and non-union following opening wedge high tibial osteotomy: surgeons’ results from 182 completed cases. Knee Surg Sports Traumatol Arthrosc, 2005, 13(1): 34-37.
17.	Iorio R, Healy WL. Unicompartmental arthritis of the knee. J Bone Joint Surg (Am), 2003, 85(7): 1351-1364.
18.	Engel GM, Lippert FG 3rd. Valgus tibial osteotomy: avoiding the pitfalls. Clin Orthop Relat Res, 1981, (160): 137-143.
19.	秦泗河, 李剛. Ilizarov 理論與技術的起源、發展與傳播史. 中國骨與關節外科, 2010, 3(5): 417-423.
20.	Nishiyama Y, Nakamura M, Henmi C, et al. Development of a three-dimensional bioprinter: construction of cell supporting structures using hydrogel and state-of-the-art inkjet technology. J Biomech Eng, 2009, 131(3): 035001.
21.	葛啟航, 萬春友, 劉亞北, 等. 脛腓骨開放骨折 Taylor 空間支架外固定術后軸向應力刺激對骨折愈合的影響研究. 中國修復重建外科雜志, 2017, 31(8): 931-935.
22.	劉釗, 萬春友, 張濤, 等. 軸向載荷分擔比測試輔助 Taylor 空間支架治療脛腓骨骨折的作用. 中華創傷雜志, 2019, 35(4): 348-353.
23.	Catagni MA, Guerreschi F, Ahmad TS, et al. Treatment of genu varum in medial compartment osteoarthritis of the knee using the Ilizarov method. Orthop Clin North Am, 1994, 25(3): 509-514.
24.	Sen C, Kocaoglu M, Eralp L. The advantages of circular external fixation used in high tibial osteotomy (average 6 years follow-up). Knee Surg Sports Traumatol Arthrosc, 2003, 11(3): 139-144.
25.	Weale AE, Lee AS, MacEachern AG. High tibial osteotomy using a dynamic axial external fixator. Clin Orthop Relat Res, 2001, (382): 154-167.
26.	Henderson DJ, Rushbrook JL, Harwood PJ, et al. What are the biomechanical properties of the Taylor spatial frame^TM? Clin Orthop Relat Res, 2017, 475(5): 1472-1482.
27.	劉少揚, 王明海. 外固定支架釘道感染的預防. 轉化醫學電子雜志, 2016, 3(1): 61-64.

1. Ivarsson I, Myrnerts R, Gillquist J. High tibial osteotomy for medial osteoarthritis of the knee. A 5 to 7 and 11 year follow-up. J Bone Joint Surg (Br), 1990, 72(2): 238-244.
2. Hernigou P, Medevielle D, Debeyre J, et al. Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study. J Bone Joint Surg (Am), 1987, 69(3): 332-354.
3. Kim HJ, Park J, Shin JY, et al. More accurate correction can be obtained using a three-dimensional printed model in open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc, 2018, 26(11): 3452-3458.
4. Altman R, Asch E, Bloch D, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum, 1986, 29(8): 1039-1049.
5. Tseng TH, Tsai YC, Lin KY, et al. The correlation of sagittal osteotomy inclination and the anteroposterior translation in medial open-wedge high tibial osteotomy-one of the causes affecting the patellofemoral joint? Int Orthop, 2019, 43(3): 605-610.
6. Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis, 1957, 16(4): 494-502.
7. 孔偉, 黃慶紅. 雙下肢站立位 DR 全長攝影在骨科矯形中的臨床價值. 中國醫藥科學, 2017, 7(3): 137-141.
8. 馬繼海, 張濤, 海碧霞, 等. 骨外固定動力化治療開放性脛腓骨骨折. 中國修復重建外科雜志, 2018, 32(2): 174-177.
9. 雍煒, 曹海鯤, 趙遠航, 等. Taylor 空間支架在脛腓骨骨折下肢力線調整中的臨床應用. 世界最新醫學信息文摘, 2018, 18(105): 31-33.
10. Lawrence RC, Felson DT, Helmick CG, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part Ⅱ. Arthritis Rheum, 2008, 58(1): 26-35.
11. Lespasio MJ, Piuzzi NS, Husni ME, et al. Knee osteoarthritis: A primer. Perm J, 2017, 21: 16-183.
12. 任燕, 石婭婭, 譚波, 等. 中國人群膝骨關節炎危險因素的 Meta 分析. 現代預防醫學, 2015, 42(12): 2282-2284, 2292.
13. 陳蕾, 李江偉, 鄭明. 腓骨高位截骨對膝關節應力改變的三維有限元分析. 中國骨與關節損傷雜志, 2018, 33(6): 583-585.
14. 張英澤, 李存祥, 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.
15. Bonasia DE, Dettoni F, Sito G, et al. Medial opening wedge high tibial osteotomy for medial compartment overload/arthritis in the varus knee: prognostic factors. Am J Sports Med, 2014, 42(3): 690-698.
16. Warden SJ, Morris HG, Crossley KM, et al. Delayed-and non-union following opening wedge high tibial osteotomy: surgeons’ results from 182 completed cases. Knee Surg Sports Traumatol Arthrosc, 2005, 13(1): 34-37.
17. Iorio R, Healy WL. Unicompartmental arthritis of the knee. J Bone Joint Surg (Am), 2003, 85(7): 1351-1364.
18. Engel GM, Lippert FG 3rd. Valgus tibial osteotomy: avoiding the pitfalls. Clin Orthop Relat Res, 1981, (160): 137-143.
19. 秦泗河, 李剛. Ilizarov 理論與技術的起源、發展與傳播史. 中國骨與關節外科, 2010, 3(5): 417-423.
20. Nishiyama Y, Nakamura M, Henmi C, et al. Development of a three-dimensional bioprinter: construction of cell supporting structures using hydrogel and state-of-the-art inkjet technology. J Biomech Eng, 2009, 131(3): 035001.
21. 葛啟航, 萬春友, 劉亞北, 等. 脛腓骨開放骨折 Taylor 空間支架外固定術后軸向應力刺激對骨折愈合的影響研究. 中國修復重建外科雜志, 2017, 31(8): 931-935.
22. 劉釗, 萬春友, 張濤, 等. 軸向載荷分擔比測試輔助 Taylor 空間支架治療脛腓骨骨折的作用. 中華創傷雜志, 2019, 35(4): 348-353.
23. Catagni MA, Guerreschi F, Ahmad TS, et al. Treatment of genu varum in medial compartment osteoarthritis of the knee using the Ilizarov method. Orthop Clin North Am, 1994, 25(3): 509-514.
24. Sen C, Kocaoglu M, Eralp L. The advantages of circular external fixation used in high tibial osteotomy (average 6 years follow-up). Knee Surg Sports Traumatol Arthrosc, 2003, 11(3): 139-144.
25. Weale AE, Lee AS, MacEachern AG. High tibial osteotomy using a dynamic axial external fixator. Clin Orthop Relat Res, 2001, (382): 154-167.
26. Henderson DJ, Rushbrook JL, Harwood PJ, et al. What are the biomechanical properties of the Taylor spatial frame^TM? Clin Orthop Relat Res, 2017, 475(5): 1472-1482.
27. 劉少揚, 王明海. 外固定支架釘道感染的預防. 轉化醫學電子雜志, 2016, 3(1): 61-64.

Chinese Journal of Reparative and Reconstructive Surgery

Clinical application of Taylor spatial frame in adjustment of lower extremity force line of knee medial compartmental osteoarthritis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content