前十字韧带缺损情况下的斜坡截骨术

IF 4.4 1区 医学 Q1 ORTHOPEDICS
Mahmut Enes Kayaalp, Philipp Winkler, Balint Zsidai, Gian Andrea Lucidi, Armin Runer, Ariana Lott, Jonathan D Hughes, Volker Musahl
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引用次数: 0

摘要

➤胫骨后斜度(PTS)≥12°是前交叉韧带(ACL)损伤和前交叉韧带重建失败的重要风险因素。PTS应严格根据侧位X光片进行测量,建议图像中胫骨近端长度为15厘米。可通过放置两个圆圈来确定胫骨近端轴线,其中一个圆圈位于胫骨结节下方,另一个圆圈位于胫骨结节下方 10 厘米处,从而进行 PTS 测量。在磁共振成像和计算机断层扫描上进行的 PTS 测量会被低估➤。可采用(1) 上截骨法、(2) 小结节反射横截骨法或 (3) 下截骨法进行斜坡减低截骨术。矫正目标仍是一个争论不休的话题。尽管存在争议,但一些学者建议将胫骨斜度略微矫正过度至 4° 至 6°。例如,如果初始斜度为 12°,那么在目标胫骨斜度为 4° 至 6° 的情况下,应进行 6° 至 8° 的矫正。然而,潜在的并发症、斜度减小截骨术对骨关节炎影响的数据有限以及对髌股关节影响的不确定性是值得关注的问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Slope Osteotomies in the Setting of Anterior Cruciate Ligament Deficiency.

➤ Posterior tibial slope (PTS) of ≥12° represents an important risk factor for both anterior cruciate ligament (ACL) injury and ACL reconstruction failure.➤ PTS measurements can significantly differ on the basis of the imaging modality and the measurement technique used. PTS should be measured on strictly lateral radiographs, with a recommended proximal tibial length of 15 cm in the image. The PTS measurement can be made by placing 2 circles to define the proximal tibial axis, 1 just below the tibial tubercle and another 10 cm below it. PTS measurements are underestimated when made on magnetic resonance imaging and computed tomography.➤ Slope-reducing osteotomies can be performed using a (1) supratuberosity, (2) tubercle-reflecting transtuberosity, or (3) infratuberosity method. The correction target remains a topic of debate. Although it is controversial, some authors recommend overcorrecting the tibial slope slightly to a range of 4° to 6°. For instance, if the initial slope is 12°, a correction of 6° to 8° should be performed, given the target tibial slope of 4° to 6°.➤ Clinical outcomes following slope-reducing osteotomies have been favorable. However, potential complications, limited data with regard to the impact of slope-reducing osteotomies on osteoarthritis, and uncertainty with regard to the effects on the patellofemoral joint are notable concerns.➤ Patients with complex deformities may need biplanar osteotomies to comprehensively address the condition.

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来源期刊
CiteScore
8.90
自引率
7.50%
发文量
660
审稿时长
1 months
期刊介绍: The Journal of Bone & Joint Surgery (JBJS) has been the most valued source of information for orthopaedic surgeons and researchers for over 125 years and is the gold standard in peer-reviewed scientific information in the field. A core journal and essential reading for general as well as specialist orthopaedic surgeons worldwide, The Journal publishes evidence-based research to enhance the quality of care for orthopaedic patients. Standards of excellence and high quality are maintained in everything we do, from the science of the content published to the customer service we provide. JBJS is an independent, non-profit journal.
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