Three-Dimensionally Measured TT-TG Distance Remains After Medial Open-Wedge High Tibial Osteotomy and Correlates With Internal Rotation of Distal Tibial Segment Below the Osteotomy Site.

IF 2.7 4区 医学 Q1 ORTHOPEDICS
Se-Han Jung, Min Jung, Kwangho Chung, Hyun-Soo Moon, Sungjun Kim, So-Heun Lee, Chong-Hyuk Choi, Sung-Hwan Kim
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引用次数: 0

Abstract

ObjectiveTo evaluate perioperative changes in anatomical parameters related to patellofemoral biomechanics, as well as cartilage repair outcomes following additional arthroscopic marrow stimulation for full-thickness trochlear cartilage defects (TCDs) during medial open-wedge high tibial osteotomy (MOWHTO).DesignA total of 38 patients (38 knees) who underwent arthroscopic marrow stimulation (microfracture or microdrilling) for TCDs combined with MOWHTO were retrospectively reviewed. The mean follow-up period was 27.0 months. Three-dimensional measurements of parameters associated with patellar biomechanics were performed. Magnetic resonance imaging and second-look arthroscopy were used to assess repaired cartilage, using Magnetic Resonance Observation of Cartilage Repaired Tissue (MOCART) knee score and International Cartilage Repair Society Cartilage repair assessment (ICRS CRA).ResultsIn 3-dimensional measurements, the tibial tubercle-trochlear groove (TT-TG) distance was maintained (mean difference: -0.6 mm, P = 0.227), whereas the modified Q-angle significantly decreased (mean difference: -1.9°, P = 0.002). The distal femur-distal tibial rotation (DF-DTR) decreased, indicating internal rotation of the distal tibial segment (mean difference: -5.3°, P < 0.001). TT-TG distance was associated with DF-DTR (r = 0.583, P = 0.001). Arthroscopic marrow stimulation for TCDs showed favorable cartilage repaired tissue, especially for the microdrilling group (median MOCART score, 70; ICRS CRA grade 1-2, 82.8%).ConclusionThe 3-dimensionally measured TT-TG distance was maintained after MOWHTO and was associated with internal rotation of the distal tibial segment below the osteotomy site. Arthroscopic marrow stimulation for TCDs in patients undergoing MOWHTO achieved favorable cartilage repaired tissue in short term.

胫骨内侧开楔高位截骨后三维测量的TT-TG距离与截骨部位下方胫骨远端段内旋相关。
目的评价内侧开楔高位胫骨截骨术(MOWHTO)中全层滑车软骨缺损(tcd)患者行额外关节镜骨髓刺激后围手术期髌股生物力学相关解剖参数的变化及软骨修复效果。回顾性分析38例(38膝)接受关节镜骨髓刺激(微骨折或微钻孔)治疗tcd合并MOWHTO的患者。平均随访时间为27.0个月。对髌骨生物力学相关参数进行三维测量。采用磁共振成像和二次关节镜对修复后的软骨进行评估,采用软骨修复组织磁共振观察(MOCART)膝关节评分和国际软骨修复学会软骨修复评估(ICRS CRA)。结果在三维测量中,胫骨结节-滑车沟(TT-TG)距离保持不变(平均差值为-0.6 mm, P = 0.227),改良后的q角明显减小(平均差值为-1.9°,P = 0.002)。股骨远端-胫骨远端旋转(DF-DTR)减小,表明胫骨远端段内旋转(平均差值:-5.3°,P < 0.001)。TT-TG距离与DF-DTR相关(r = 0.583, P = 0.001)。关节镜下骨髓刺激tcd显示良好的软骨修复组织,特别是微钻孔组(MOCART中位数评分,70;ICRS CRA 1-2级,82.8%)。结论MOWHTO后三维测量的TT-TG距离保持不变,且与截骨部位下方胫骨远端段的内旋有关。关节镜下骨髓刺激治疗MOWHTO患者在短期内获得了良好的软骨修复组织。
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来源期刊
CARTILAGE
CARTILAGE ORTHOPEDICS-
CiteScore
6.90
自引率
7.10%
发文量
80
期刊介绍: CARTILAGE publishes articles related to the musculoskeletal system with particular attention to cartilage repair, development, function, degeneration, transplantation, and rehabilitation. The journal is a forum for the exchange of ideas for the many types of researchers and clinicians involved in cartilage biology and repair. A primary objective of CARTILAGE is to foster the cross-fertilization of the findings between clinical and basic sciences throughout the various disciplines involved in cartilage repair. The journal publishes full length original manuscripts on all types of cartilage including articular, nasal, auricular, tracheal/bronchial, and intervertebral disc fibrocartilage. Manuscripts on clinical and laboratory research are welcome. Review articles, editorials, and letters are also encouraged. The ICRS envisages CARTILAGE as a forum for the exchange of knowledge among clinicians, scientists, patients, and researchers. The International Cartilage Repair Society (ICRS) is dedicated to promotion, encouragement, and distribution of fundamental and applied research of cartilage in order to permit a better knowledge of function and dysfunction of articular cartilage and its repair.
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