Xiangzhi Yin, Quan Wang, Yijie Tang, Yingze Zhang, Tengbo Yu, Yi Zhang
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引用次数: 0
Abstract
Background: To investigate the relationship between the distance from the medial tibial osteotomy point to the medial tibial edge and the development of lateral tibial hinge fracture (type II) and intra-articular tibial plateau fracture (type III) in patients who have degenerative disease undergoing open wedge high tibial osteotomy (OWHTO). This information will aid surgeons in avoiding the occurrence of fractures.
Methods: This retrospective study analyzed 304 patients who underwent OWHTO from January 2018 to January 2024 in the Affiliated Hospital of Qingdao University. The distance from the tibial osteotomy point to the medial tibial edge on imaging was analyzed to determine its association with fracture. A one-way analysis of variance was used to compare the differences in height, weight, body mass index, the distance from the medial tibial osteotomy point to the medial tibial edge, sex, left and right sides of the knee, and osteoporosis in the occurrence of types II and III fractures. Receiver operating characteristic curves were used to identify the critical distances associated with type II and type III fractures. Logistic regression analyses were used to obtain the OR of the critical distance adjusted for age, sex, left and right sides, body mass index, and T value.
Results: There were 40 fractures (13.3%) in 304 patients after OWHTO, comprising 21 type II fractures (7.0%) and 19 type III fractures (6.3%). A single-factor variance analysis showed that the tibial bone cutting distance to the medial tibial edge (P = 0.02) and osteoporosis (P = 0.01) were significantly different from the fracture. Receiver operating characteristic curves showed that the critical distances for types II and III fractures were 40.5 and 47.1 mm, respectively. Logistic regression analysis showed that the ORs [odds ratios] of types II and III fractures were 1.061 (95% CI [confidence interval] = 1.010 to 1.115) and 1.064 (95% CI = 1.011 to 1.119), respectively.
Conclusions: In patients undergoing OWHTO, the risk factors for type II and III fractures are osteoporosis and the distance from the tibial bone cutting point to the medial tibial edge. This distance should be minimized during OWHTO to avoid type II and III fractures.
目的研究胫骨内侧截骨点到胫骨内侧边缘的距离与接受开放性楔形高位胫骨截骨术(OWHTO)的退行性疾病患者发生胫骨外侧铰链骨折(II型)和胫骨关节内平台骨折(III型)的关系。这些信息将有助于外科医生避免骨折的发生:这项回顾性研究分析了2018年1月至2024年1月在青岛大学附属医院接受OWHTO手术的304例患者。分析了影像学上胫骨截骨点到胫骨内侧边缘的距离,以确定其与骨折的相关性。采用单因素方差分析比较了身高、体重、体重指数(BMI)、胫骨内侧截骨点到胫骨内侧边缘的距离、性别、膝关节左右侧以及骨质疏松症在II型和III型骨折发生中的差异。利用接收器操作特征曲线确定了与 II 型和 III 型骨折相关的临界距离。采用逻辑回归分析得出临界距离的几率(OR),并对年龄、性别、左右侧、体重指数和 T 值进行调整:结果:304 名患者在接受 OWHTO 治疗后发生了 40 例骨折(13.3%),其中 II 型骨折 21 例(7.0%),III 型骨折 19 例(6.3%)。单因素方差分析显示,胫骨内侧边缘的切骨距离(P = 0.02)和骨质疏松症(P = 0.01)与骨折有显著差异。接收者操作特征曲线显示,II型和III型骨折的临界距离分别为40.5毫米和47.1毫米。逻辑回归分析显示,II型和III型骨折的OR值分别为1.061(95% CI [置信区间] = 1.010至1.115)和1.064(95% CI = 1.011至1.119):在接受OWHTO手术的患者中,II型和III型骨折的风险因素是骨质疏松症和胫骨切点到胫骨内侧边缘的距离。在进行 OWHTO 时应尽量减少这一距离,以避免 II 型和 III 型骨折的发生。
期刊介绍:
The Journal of Arthroplasty brings together the clinical and scientific foundations for joint replacement. This peer-reviewed journal publishes original research and manuscripts of the highest quality from all areas relating to joint replacement or the treatment of its complications, including those dealing with clinical series and experience, prosthetic design, biomechanics, biomaterials, metallurgy, biologic response to arthroplasty materials in vivo and in vitro.