胫骨高位截骨治疗膝关节骨性关节炎  

High tibial osteotomy for the treatment of osteoarthritis of the knee

作　　者：张功林[1] 章鸣[1] 蔡国荣[1] 郭翱[1] 张文正[1] 胡玉祥[1] 丁法明[1] 

机构地区：[1]温岭市骨伤科医院,浙江温岭317500

出　　处：《中国骨伤》2008年第3期211-212,共2页China Journal of Orthopaedics and Traumatology

摘　　要：目的:总结外侧闭合楔形胫骨高位截骨术(high tibial osteotomy,HTO)治疗膝关节单间室骨性关节炎引起的关节疼痛临床应用结果。方法:应用外侧闭合楔形HTO治疗9例(男3例,女6例)伴内翻畸形的膝关节单间室骨性关节炎。年龄52～58岁,平均56岁。术中显露胫腓关节近侧,切开前侧关节囊,用骨锯或骨刀去除外侧楔形骨块,闭合截骨处缺损后用"U"形钉固定。结果:手术顺利,无手术并发症,经2～5.5年(平均3.5年)随访,按膝关节骨性关节炎疗效评定标准:优5例,良好3例,尚可1例。结论:外侧闭合楔形HTO是治疗膝关节单间室骨性关节炎引起关节疼痛的有效手术方法,但不适用于年龄过大的患者(>60岁)。Objective：To summarize clinical application of the high tibial osteatomy（HTO）with lateral closing-wedge for the treatment of pain of unicompartmental osteoarthritis of the knee. Methods： From February 2000 to February 2004,9 patients （3 males and 6 females,ranging in age from 52 to 58 years,with an average of 56 years）with unicompartmental osteoarthritis of the knee treated by HTO with lateral closing-wedge. The proximal tibiofibular joint was exposed, the anterior part of the capsule was incised, and to remove a laterally based wedge with saw cuts and osteotomes. Stepped staples were used for the fixation of tibial osteotomies after closing the defect of osteotomy. Results：The operative course was uneventful. There were no complications after operation. The postoperative follow-up period ranged from 2 to 5.5 years（mean,3.5 years）. The results were evaluated with functional assessment criterion of the osteoarthritis of the knee ,among the 9 cases, excellent was in 5 cases, good in 3 cases, fair in 1 case. Conclusion： HTO with lateral closing-wedge is an effective operative method for the treatment of pain of unicompartmental osteoarthritis of the knee, but except for older patients over 60 years.

关 键 词：截骨术 胫骨 膝关节 骨关节炎 

分 类 号：R684.3[医药卫生—骨科学] R726.847[医药卫生—外科学]