■在精心挑选的膝关节外翻患者中,股骨远端截骨术(DFO)可以在中长期随访中改善症状,减少骨关节炎进展。迄今为止,目前文献中没有关于术后关节线倾斜(JLO)在外翻畸形矫正中的作用的明确证据.
为了评估内侧闭合楔形DFO(MCW-DFO)治疗膝关节外翻的临床和放射学结果,考虑到胫骨和股骨畸形,以及根据JLO边界(≤4°)验证MCW-DFO的有效性和安全性。
■队列研究;证据水平,3.
■对一组膝关节外翻患者进行回顾性分析。患者分为两组:股骨外翻(FB-V)和胫骨外翻(TB-V)。手术前和最后一次随访时收集膝关节X光片。通过几个经过验证的评分来评估临床结果(国际膝关节文献委员会,膝盖社会得分,膝关节损伤和骨关节炎结果评分,Tegner,数字评级量表,克罗斯比-因索尔)。
■本研究共纳入30例患者(34膝),平均年龄49.3±9.1岁。总体平均随访时间为9.4±5.9年。术前平均髋-膝-踝角度为187.6°±3.3°(范围,181.5°-191°),术后角度为180°±3.1°(范围,176°-185°)。两组术后JLO大多在≤4°的安全区内(TB-V组4例患者和FB-V组1例患者术后JLO>4°),尽管FB-V膝关节表现出显着的优越JLO矫正(TB-V组的术后JLO:平均值,4.0°±2.5°[P=.1];FB-V组术后JLO:平均值,2.4°±1.4°[P=.5])。两组临床评分均有显著改善(P<0.01)。此外,在最后一次随访时,骨关节炎的严重程度并未恶化.
■MCW-DFO是治疗病理性膝关节外翻的有效方法,不管畸形的部位。FB-V组和TB-V组在临床评分方面均显示出可比的改善,骨关节炎的发展,和一个中性的机械轴的恢复。值得注意的是,与TB-V相比,FB-V膝盖获得了更多的JLO校正。
UNASSIGNED: In carefully selected patients with an arthritic valgus knee, distal femoral osteotomy (DFO) can improve symptoms at medium- to long-term follow-up, reducing osteoarthritis progression. To date, there is no clear evidence in the current literature regarding the role of postoperative joint line obliquity (JLO) in valgus deformity correction.
UNASSIGNED: To assess the clinical and radiological outcomes of medial closing-wedge DFO (MCW-DFO) for the treatment of valgus knees, considering both tibial- and femoral-based deformities, as well as to verify the efficacy and safety of MCW-DFO according to JLO boundaries (≤4°).
UNASSIGNED: Cohort study; Level of evidence, 3.
UNASSIGNED: A retrospective analysis was conducted on a cohort of patients with valgus knees. Patients were divided into 2 groups: femoral-based valgus (FB-V) and tibial-based valgus (TB-V). Knee
radiographs were collected before surgery and at the last follow-up. The clinical outcome was evaluated through several validated scores (International Knee Documentation Committee, Knee Society Score, Knee injury and Osteoarthritis Outcome Score, Tegner, Numeric Rating Scale, Crosby-Insall).
UNASSIGNED: A total of 30 patients (34 knees) with a mean age of 49.3 ± 9.1 years were included in the study. The overall mean follow-up was 9.4 ± 5.9 years. The mean preoperative hip-knee-ankle angle was 187.6°± 3.3° (range, 181.5°-191°) and the postoperative angle was 180°± 3.1° (range, 176°-185°). Most postoperative JLOs were within the safe zone of ≤4° in both groups (the postoperative JLO was >4° in 4 patients in the TB-V group and 1 patient in the FB-V group), although FB-V knees exhibited significant superior JLO correction (postoperative JLO in the TB-V group: mean, 4.0°± 2.5° [P = .1]; postoperative JLO in the FB-V group: mean, 2.4°± 1.4° [P = .5]). Significant improvements in all clinical scores were observed in both groups (P < .01). Additionally, the severity of the osteoarthritis did not worsen at the last follow-up.
UNASSIGNED: MCW-DFO is an effective procedure for treating pathological valgus knees, regardless of the site of the deformity. Both FB-V and TB-V groups showed comparable improvements in the clinical scores, development of osteoarthritis, and the restoration of a neutral mechanical axis. Notably, FB-V knees achieved more JLO correction compared with the TB-V ones.