[1]张世峰 金群华. 胫骨高位截骨术治疗膝内侧单间室骨关节炎的研究进展[J].中华老年骨科与康复电子杂志,2018,(05):312-317.
　Zhang Shifeng,Jin Qunhua.. Research progress of high tibial osteotomy in the treatment of medial single compartment osteoarthritis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2018,(05):312-317.
点击复制

 胫骨高位截骨术治疗膝内侧单间室骨关节炎的研究进展()
分享到：

中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2018年05期
页码:
312-317
栏目:
述评
出版日期:
2018-10-05

文章信息/Info

Title:
 Research progress of high tibial osteotomy in the treatment of medial single compartment osteoarthritis
作者:
张世峰1 金群华2
750004 银川，宁夏医科大学1；750004 银川，宁夏医科大学总医院骨三科2
Author(s):
 Zhang Shifeng1;  Jin Qunhua2.
 1Ningxia Medical University, Yinchuan 750004, China, 2Department of Orthopedic, General Hospital of Ningxia Medical University, Yinchuan 750004, China
关键词:
 ; 胫骨;  截骨术;  关节炎; 膝;  关节成形术; 置换; 膝
Keywords:
 ; Tibial;  Osteotomy;  Osteoarthritis;  knee;  Arthroplasty;  replacement;  knee
文献标志码:
A
摘要:
 骨关节炎（OA）是一种以软骨退行性变为主的疾病。该病常见于老年患者，病程末期可致严重的关节畸形，给患者的心理和生理带来极大的痛苦。胫骨高位截骨术（HTO）作为治疗单间室膝关节骨性关节炎（KOA）的手术方式，是一种安全、可靠的治疗方式。现已被广大医生及患者接受，特别是年轻患者的接受度更高。该技术的主要目的是改变下肢畸形力线，以延缓或解除内侧间室KOA的退行性改变。HTO一直被认为具有技术简单、手术创伤小、畸形矫正精确、术后恢复快等优点。多年来，随着手术技术的不断创新、内固定的不断改良，手术的适应证变得更为广泛。目前普遍认为HTO是一种比较理想的手术方式，长期临床效果良好。本文对近年来胫骨高位截骨术治疗单间室骨性关节炎的术前选择、手术方式、术后疗效、术后并发症及术后长期疗效进行综述。
Abstract:
 Osteoarthritis (OA) is a disease mainly present with cartilage degeneration. It is common in elderly patients and at the end course severe joint deformities may occur, causing great psychological and physical pain to the patient. High tibial osteotomy (HTO) is a safe and reliable surgical method for the treatment of single compartment knee osteoarthritis. It has been widely accepted by doctors and patients, especially among young patients. The mainpurpose of this technique is to modify the lower limb deformities in order to delay or eliminate the degenerative changes of medial compartment osteoarthritis. HTO has been considered to be a simple technology, less surgical trauma, accurate deformity correction, rapid postoperative recovery and so on. Over years, with the continuous innovation of surgical techniques and the continuous improvements of internal fixation, the indications for HTO have been extended. At present, it is generally believed that HTO is an ideal surgical method and can obtain good and long-term clinical results. This article reviews recent preoperative selection, surgical methods, postoperative efficacy, postoperative complications and long-term postoperative efficacy of high tibial osteotomy for single-compartment osteoarthritis.

参考文献/References:

 
1 Fujisawa Y, Masuhara K, Shiomi S. The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints [J]. Orthop Clin North Am, 1979, 10(3): 585-608.
2 Jackson JP, Waugh W. Tibial osteotomy for osteoarthritis of the knee [J]. Acta Orthopaedica Belgica, 1982, 43(10): 93-96.
3 Coventry MB. Osteotomy of the upper portion of the tibia for degenerative arthritis of the knee.A preliminary report.1965 [J]. Clin OrthopRelat Res, 1989, 47(248): 4-8.
4 Kohn D, Pape D. The Knee Joint [M]. Paris: Springer-Verlag France, 2012: 611-619.
5 Lobenhoffer P, Agneskirchner JD. The Knee Joint [M]. Paris: Springer-Verlag France, 2012: 621-632.
6 Efe T, Ahmed G, Heyse TJ, et al. Closing-wedge high tibial osteotomy: survival and risk factor analysis at long-term follow up [J]. BMC Musculoskelet Disord, 2011, 12(1): 46.
7 Choi HR, Hasegawa Y, Kondo S, et al. High tibial osteotomy for varus gonarthrosis: a 10- to 24-year follow-up study [J]. J Orthop Sci, 2001, 6(6): 493-497.
8 Flamme CH, Rühmann O, Schmolke S, et al. Long-term outcome following high tibial osteotomy with tension Bend principle [J]. Arch Orthop Trauma Surg, 2003, 123(1): 12-16.
9 Billings A, Scott DF, Camargo MP, et al. High tibial osteotomy with a calibrated osteotomy guide, rigid internal fixation, and early motion-Long-term follow-up [J]. JBone Joint SurgAm, 2000, 82(1): 70-79.
10 Meidinger G, Imhoff AB, Paul J, et al. May smokers and overweight patients be treated with a medial open-wedge HTO? Risk factors for non-union [J]. Knee Surg Sports Traumatol Arthrosc, 2011, 19(3): 333-339.
11 Stucki G, Meier D, Stucki S, et al. [Evaluation of a German version of WOMAC (Western Ontario and McMaster Universities) Arthrosis Index][J]. ZRheumatol, 1996, 55(1):40.
12 Prakash J, Song EK, Lim HA, et al. High tibial osteotomy accelerates lateral compartment osteoarthritis in discoid meniscus patients[J]. Knee SurgSports Traumatol Arthrosc, 2017[Epub ahead of print].
13 Shaw JA, Moulton MJ. High tibial osteotomy:an operation based on a spurious mechanical concept.A theoretic treatise [J]. Am J Orthop, 1996, 25(6): 429-436.
14 Dugdale TW, Noyes FR, Styer D. Preoperative planning for high tibial osteotomy. The effect of lateral tibiofemoral separation and tibiofemoral length[J].Clin Orthop Relat Res, 1992, 274: 248-264.
15 Aglietti P, Rinonapoli E, Stringa G, et al. Tibial osteotomy for the varus osteoarthritic knee [J]. Clin Orthop Relat Res, 1983 (176): 239-251.
16 Matthews LS, Goldstein SA, Malvitz TA, et al. Proximal tibial osteotomy.Factors that influence the duration of satisfactory function [J]. ClinOrthopRelatRes, 1988, 229: 193-200.
17 Gstottner M, Pedross F, Liebensteiner M, et al. Long-term outcome after high tibial osteotomy [J]. Arch Orthop Trauma Surg, 2008, 128(1): 111-115.
18 Benzakour T, Hefti A, Lemseffer M, et al. High tibial osteotomy for medial osteoarthritis of the knee: 15 years follow-up [J]. Int Orthop, 2010, 34(2, SI): 209-215.
19 Saragaglia D, Blaysat M, Inman D, et al. Outcome of opening wedge high tibial osteotomy augmented with a Biosorb? wedge and fixed with a plate and screws in 124 patients with a mean of ten years follow-up [J]. Int Orthop, 2011, 35(8): 1151-1156.
20 Spahn G, Hofmann GO, Von Engelhardt LV, et al. The impact of a high tibial valgus osteotomy and unicondylar medial arthroplasty on the treatment for knee osteoarthritis: a meta-analysis [J]. Knee Surg Sports Traumatol Arthrosc, 2013, 21(1): 96-112.
21 Bonasia DE, Governale G, Spolaore S, et al. High tibial osteotomy [J]. Curr Rev Musculoskelet Med, 2014, 7(4): 292-301.
22 Bonasia DE, Dettoni F, Sito GA, et al. Medial opening wedge high tibial osteotomy for medial compartment overload/arthritis in the varus knee: prognostic factors [J]. Am J Sports Med, 2014, 42(3): 690-698.
23 Duivenvoorden T, van Diggele P, Reijman M, et al. Adverse events and survival after closing- and opening-wedge high tibial osteotomy: a comparative study of 412 patients [J]. Knee Surg Sports Traumatol Arthrosc, 2017, 25(3): 895-901.
24 Huizinga MR, Gorter J, Demmer A, et al. Progression of medial compartmental osteoarthritis 2-8 years after lateral closing-wedge high tibial osteotomy [J]. Knee Surg Sports Traumatol Arthrosc, 2017, 25(12): 3679-3686.
25 Polat G, Balc? H?, Çakmak MF, et al. Long-term results and comparison of the three different high tibial osteotomy and fixation techniques in medial compartment arthrosis [J].JOrthopSurgRes, 2017, 12(1):44.
26 Wootton JR, Ashworth MJ, Maclaren CA. Neurological complications of high tibial osteotomy--the fibular osteotomy as a causative factor: a clinical and anatomical study[J]. Ann R Coll Surg Engl, 1995, 77(1): 31-34.
27 Tunggal JA, Higgins GA, Waddell JP. Complications of closing wedge high tibial osteotomy [J]. Int Orthop, 2010, 34(2): 255-261.
28 Wu LD, HahneHJ, Hassenpflug J. A long-term follow-up study of high tibial osteotomy for medial compartment osteoarthrosis [J]. Zhonghua Wai Ke Za Zhi, 2004, 42(8): 474-477.
29 Wang F, Chen B, Gao S. High tibial osteotomy and arthroscopic management for the treatment of varus gonarthrosis[J]. Hebei MedJ, 2005.
30 Bauer T, Hardy P, Lemoine J, et al. Drop foot after high tibial osteotomy: a prospective study of aetiological factors [J]. Knee Surg Sports Traumatol Arthrosc, 2005, 13(1): 23-33.
31 Bin SI, Kim HJ, Ahn HS, et al. Changes in patellar height after opening wedge and closing wedge high tibial osteotomy: a meta-analysis [J]. Arthroscopy, 2016, 32(11): 2393-2400.
32 Ducat A, Sariali E, Lebel B, et al. Posterior tibial slope changes after opening-and closing-wedge high tibial osteotomy: A comparative prospective multicenter study [J]. OrthopTraumatolSurgRes, 2012, 98(1): 68-74.
33 Luo D, Zhang H, Zhang W. Comparison of three different approaches in periacetabular osteotomy[J]. Ther Clin Manag, 2016, 12: 67-72.
34 Ozel O, Yucel B, Mutlu S, et al. Changes in posterior tibial slope angle in patients undergoing open-wedge high tibial osteotomy for varus gonarthrosis [J]. Knee SurgSports TraumatolArthrosc, 2017, 25(1): 314-318.
35 Smith TO, Sexton D, Mitchell P, et al. Opening-or closing-wedged high tibial osteotomy: ameta-analysis of clinical and radiological outcomes [J]. Knee, 2011, 18(6): 361-368.
36 Harris JD, Mcneilan R, Siston RA, et al. Survival and clinical outcome of isolated high tibial osteotomy and combined biological knee reconstruction [J]. Knee, 2013, 20(3): 154-161.
37 Brouwer RW, Biermazeinstra SM, Van Raaij TM, et al. Osteotomy for medial compartment arthritis of the knee using a closing wedge or an opening wedge controlled by a Puddu plate.A one-year randomised,controlled study [J]. JBoneJoint Surg Br,2006,88(11): 1454-1459.

相似文献/References:

[1]鲍飞龙 刘涛 亢世杰 黄东生 江涛 胡义明. 双反牵引装置治疗Schatzker分型Ⅴ、Ⅵ型胫骨平台骨折的优势[J].中华老年骨科与康复电子杂志,2018,(05):266.
　Bao Feilong,Liu Tao,Kang Shijie,et al.The advantage of homeopathic double reverse traction device treating tibial plateau fractures of typing Schatzker Ⅴ and Ⅵ[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2018,(05):266.
[2]王哲培 张凯 保罗 汪毅 白震民. 太极拳对老年女性下肢静态平衡、本体感觉与功能活动的影响[J].中华老年骨科与康复电子杂志,2018,(05):296.
　Wang Zhepei,Zhang Kai,Pablo,et al. The influence of Taijiquan on the lower limbs static balance, proprioception and functional activities of older women[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2018,(05):296.
[3]刘磊 王宝泉 孙然 杨宗酉 孙家元 陈伟 王海立 殷兵 刘松 李石伦 杨光 张英泽. 2010年至2011年中国东部和西部地区成人股骨转子间骨折流行病学对比分析[J].中华老年骨科与康复电子杂志,2018,(05):302.
　Liu Lei,Wang Baoquan,Sun Ran,et al.Epidemiological comparison of adult femoral intertrochanteric fractures between the east and west areas in China from 2010 through 2011[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2018,(05):302.
[4]吴石磊 刘勇 邵增务 田青. 骨组织细胞外泌体对骨代谢作用的研究现状[J].中华老年骨科与康复电子杂志,2018,(05):308.
　Wu Shilei,Liu Yong,Shao Zengwu,et al. Research status of bone tissue-derived exosomes on bone metabolism[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2018,(05):308.
[5]赵永辉,陆声,马宇龙,等. 皮质骨通道螺钉技术在腰椎退变性疾病中的临床应用[J].中华老年骨科与康复电子杂志,2019,(03):123.[doi:10.3877/cma.j.issn.2096-0263.2019.001]
　Zhao Yonghui,Lu Sheng,Ma Yulong,et al. Clinical application of cortical bone screw technique in elderly patients with lumbar degenerative diseases[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2019,(05):123.[doi:10.3877/cma.j.issn.2096-0263.2019.001]
[6]王虎 李明 靳泽岳 连晓东 陈伟. 不同方法治疗老年股骨转子间合并转子下骨折的比较[J].中华老年骨科与康复电子杂志,2019,(03):135.[doi:DOI：10.3877/cma.j.issn.2096-0263.2019.003]
　Wang Hu,Chen Wei.. Comparative of different methods for the treatment of intertrochanteric-subtrochanteric fracture[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2019,(05):135.[doi:DOI：10.3877/cma.j.issn.2096-0263.2019.003]
[7]明立功 孟维娜 明朝戈 栗贡策 王自方 王新德 明立山 许振华.腓骨近端截骨联合中医药治疗膝关节内侧间室骨关节炎肝肾不足、气滞血瘀证[J].中华老年骨科与康复电子杂志,2019,(03):149.[doi:DOI：10.3877/cma.j.issn.2096-0263.2019.005]
　Ming Ligong,Meng Weina,Ming Chaoge,et al. Proximal fibular osteotomy combined with traditional Chinese medicine in the treatment of osteoarthritis of medial compartment of knee joint with liver and kidney insufficiency, qi stagnation and blood stasis syndrome[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2019,(05):149.[doi:DOI：10.3877/cma.j.issn.2096-0263.2019.005]
[8]胡建平 李俊峰 秦鸿雁 张强 张卫国 陈明. 长短髓内钉治疗老年股骨反转子间骨折的疗效比较[J].中华老年骨科与康复电子杂志,2019,(03):143.[doi:DOI：10.3877/cma.j.issn.2096-0263.2019.004]
　Hu Jianping,Li Junfeng,Qin Hongyan,et al. Comparison of short intramedullary nail and long intramedullary nail for the treatment of reverse oblique intertrochanteric fractures in the elderly[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2019,(05):143.[doi:DOI：10.3877/cma.j.issn.2096-0263.2019.004]
[9]魏宁 常文利 杜晨光 侯志勇 张世强 焦振清 李增炎 陈伟 张英泽. 河北医科大学第三医院956例后踝骨折的流行病学分析[J].中华老年骨科与康复电子杂志,2019,(03):167.[doi:DOI：10.3877/cma.j.issn.2096-0263.2019.008]
　Wei Ning,Chang Wenli,Du Chenguang,et al. The retrospective analysis of 956 cases with posterior malleolar fractures[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2019,(05):167.[doi:DOI：10.3877/cma.j.issn.2096-0263.2019.008]
[10]张禄锴 张博雅 张治金 朱芳兵 侯桥 全仁夫. 髌下脂肪垫对全膝关节置换术后患者膝关节功能恢复影响的meta分析[J].中华老年骨科与康复电子杂志,2019,(03):173.[doi:DOI：10.3877/cma.j.issn.2096-0263.2019.009]
　Zhang Lukai,Zhang Boya,Zhang Zhijin,et al. Effect of infrapatellar fat pad on the knee functional recovery following total knee replacement in patients: a Meta-analysis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2019,(05):173.[doi:DOI：10.3877/cma.j.issn.2096-0263.2019.009]

备注/Memo

备注/Memo:
 兴庆区膝关节炎防治技术应用示范（2014KJHM）
更新日期/Last Update: 2019-01-28