外侧闭合楔形高胫骨截骨术是 55 岁以下内侧室骨关节炎患者的长久选择

IF 2 Q2 ORTHOPEDICS

Journal of Experimental Orthopaedics Pub Date : 2024-10-16 DOI:10.1002/jeo2.70040

Ahmed Mahmoud, Bashirr Garba, Tim McMeniman, Brett Collins, Peter McMeniman, Peter Myers

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引用次数: 0

摘要

目的评估闭合楔形胫骨高位截骨术（CWHTO）的存活率，失败定义为进展为全膝关节置换术（TKA）和围术期并发症。方法本研究纳入了在一个中心接受 CWHTO 手术的患者。研究人员从病历中收集了患者的人口统计学特征、手术数据和患者报告的结果指标。评估的结果包括手术进展、并发症和患者报告的结果。澳大利亚关节登记处用于评估哪些患者进展为TKA。二元物流回归用于确定所收集的因素中是否有任何因素会增加转为关节成形术的可能性。采用 Kaplan-Meier 生存分析法进行生存分析，失败定义为进展为 TKA。结果 354 名（男性 244 名，女性 110 名）患者参与了研究。患者的平均年龄为 51 岁，平均随访时间为 18 年。55 岁以下的患者进展为 TKA 的比例较低。15年后，55岁以下和55岁以上患者进展为TKA的比例分别为64%和85%。并发症发生率为6%，无任何腓总神经麻痹。结论 CWHTO 是一种很好的手术选择，尤其适用于 55 岁以下的患者。此外，该技术的总体并发症发生率较低，且不存在人们经常担心的腓肠神经麻痹并发症。证据等级 III 级，回顾性研究。

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Lateral closing wedge high-tibial osteotomy is a long-lasting option for patients under the age of 55 with medial compartment osteoarthritis

Purpose

Assess the survival of the closing wedge high tibial osteotomy (CWHTO) with failure defined as progression to total knee arthroplasty (TKA) and perioperative complications.

Methods

Patients undergoing CWHTO in a single centre were included in this study. The patient's demographics, operative data and patient-reported outcome measures were collected from the medical records. The outcomes assessed were progression to TKA, complications and patient-reported outcome measures. The Australian joint registry was used to assess which patients progressed to TKA. A binary logistics regression is used to determine if any of the collected factors increase the likelihood of conversion to arthroplasty. Survival analysis is conducted using a Kaplan–Meier survivorship analysis with failure defined as progression to TKA.

Results

Three hundred and fifty-four (244 males and 110 females) patients were included in the study. The average age of the group was 51 years with an average follow-up of 18 years. Patients under the age of 55 had a lower rate of progression to TKA. At 15 years, the rate of progression to TKA was 64% and 85% for those under the age of 55 and over 55, respectively. The complication rate was 6% without any peroneal nerve palsies.

Conclusion

CWHTO is a good surgical option particularly when indicated in patients under the age of 55. Additionally, this technique results in a low overall complication rate with an absence of the often-feared complication of peroneal nerve palsy.