胫骨高位截骨术治疗膝关节不稳定的临床结果和长期疗效:一项最新的系统综述。

IF 1.8 Q2 ORTHOPEDICS
SICOT-J Pub Date : 2025-01-01 Epub Date: 2025-01-23 DOI:10.1051/sicotj/2024061
Edi Mustamsir, Aulia Pandu Aji, Ahmad Abdilla Adiwangsa, Azfar Ahnaf Akmalizzan
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引用次数: 0

摘要

膝关节的稳定性受受力分布和韧带结构的影响。胫骨高位截骨术(HTO)治疗膝关节畸形并重新分配负荷,减少进一步的侵入性手术。胫骨高位截骨术(HTO)是一种成熟的治疗膝关节不稳定的手术,特别是在韧带缺陷的情况下,如前交叉韧带(ACL)和前交叉韧带(PCL)功能不全。本系统综述旨在评估HTO在改善膝关节稳定性和功能方面的临床结果和长期疗效。方法:使用Cochrane Central、PubMed、MEDLINE和ProQuest数据库对2000年至2024年6月间发表的研究进行系统文献检索。符合条件的研究包括人类受试者,随访至少6个月,重点关注HTO对膝关节不稳定的影响。排除标准包括动物研究、非膝关节研究和综述。提取了患者人口统计学、随访时间、主观和客观结果以及并发症的数据。结果:在536项研究中,11项符合纳入标准,包括303例患者。HTO联合ACL或PCL重建显著改善了主观不稳定性和客观指标,包括Lachman和Pivot Shift测试评分。患者满意度高,功能评分如Lysholm和Tegner明显改善。并发症的发生率很低,只有感染和延迟愈合等小问题,没有移植物失败的报道。结论:HTO,特别是联合韧带重建,可有效治疗前交叉韧带或前交叉韧带缺陷所致的膝关节不稳。该手术具有良好的中长期疗效,患者满意度高,并发症发生率低。对于膝关节不稳定的患者,它仍然是一个可行的选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical outcomes and long-term efficacy of high tibial osteotomy in treating knee instability: An updated systematic review.

Introduction: Knee joint stability is influenced by force distribution and ligament structures. High Tibial Osteotomy (HTO) treats knee deformities and redistributes load, reducing further invasive procedures. High Tibial Osteotomy (HTO) is a well-established procedure for addressing knee instability, particularly in cases involving ligament deficiencies such as ACL and PCL insufficiencies. This systematic review aims to evaluate the clinical outcomes and long-term efficacy of HTO in improving knee stability and function.

Methods: A systematic literature search was conducted using Cochrane Central, PubMed, MEDLINE, and ProQuest databases for studies published between 2000 and June 2024. Eligible studies included human subjects with at least six months of follow-up and focused on HTO for knee instability. Exclusion criteria included animal studies, non-knee joint studies, and reviews. Data on patient demographics, follow-up duration, subjective and objective outcomes, and complications were extracted.

Results: Out of 536 studies identified, 11 met the inclusion criteria, encompassing 303 patients. Combining HTO with ACL or PCL reconstruction significantly improved both subjective instability and objective measures, including Lachman and Pivot Shift test grades. Patient satisfaction was high, and functional scores such as Lysholm and Tegner improved markedly. The incidence of complications was low, with minor issues such as infections and delayed union, and no reported graft failures.

Conclusion: HTO, particularly when combined with ligament reconstruction, effectively treats knee instability due to ACL or PCL deficiency. The procedure demonstrates strong mid- to long-term outcomes, high patient satisfaction, and a low rate of complications. It remains a viable option for patients with knee instability.

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来源期刊
SICOT-J
SICOT-J ORTHOPEDICS-
CiteScore
3.20
自引率
12.50%
发文量
44
审稿时长
14 weeks
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