| Autor: |
Hongsen Chiang, Hsi-Ching Hsu, Ching-Chuan Jiang |
| Jazyk: |
angličtina |
| Rok vydání: |
2006 |
| Předmět: |
|
| Zdroj: |
Journal of the Formosan Medical Association, Vol 105, Iss 3, Pp 214-219 (2006) |
| Druh dokumentu: |
article |
| ISSN: |
0929-6646 |
| DOI: |
10.1016/S0929-6646(09)60308-9 |
| Popis: |
High tibial osteotomy (HTO) is a well-established treatment for unicompartmental gonarthrosis of the knee, but its durability and complications remain controversial. We previously introduced a novel dome-shaped HTO, and the long-term follow-up results using this technique are analyzed in this study. Methods: We treated 25 varus knees in 22 patients with medial gonarthrosis, using a specially designed calibrated cutting jig along with rigid external fixation and early joint motion postoperatively. A total of 16 patients (19 knees) completed the study protocol and were followed up for 13-16 years (mean, 15 years). Results: The surgery attempted to obtain 8° valgus; the actual postoperative alignment averaged 12.4° valgus, which decreased significantly to 7.8° valgus after 5 years. The outcome as assessed by the Hospital for Special Surgery knee score was excellent or good in 18 knees at 5 years postoperatively, and in 13 knees at the final follow-up, showing a significant deterioration with time. Loss of correction with time was not correlated with the postoperative alignment achieved: at 5 years, loss greater than 2° was found in 12 knees, but their mean corrected angle (11.8° valgus) was not significantly different from that of the others (13.3° valgus). Nor was the loss of correction correlated with the knee scores. The mean amount of joint motion after surgery did not change significantly with time: 124° preoperatively and 114° at the final follow-up. The patellar position also did not change from preoperative values during postoperative follow-up: mean Insall-Salvati index was 0.88 before and 0.90 5 years after surgery, neither showing patella baja. Conclusion: Dome-shaped HTO is a durable time-buying procedure for patients with unicompartmental medial gonarthrosis, and can avoid subsequent development of patella baja that may complicate further prosthetic arthroplasty. |
| Databáze: |
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