胫骨高位截骨术治疗老年膝关节内侧间室炎的疗效研究

doi:10.3969/j.issn.1003-9198.2024.01.014

Abstract

Abstract: Objective To compare the efficacy of high tibial osteotomy (HTO) in treating medial compartment knee osteoarthritis in elderly and non-elderly patients. Methods The clinical data of 26 patients who underwent HTO surgery were retrospectively analyzed. The patients were divided into elderly group (aged ≥60 years, n=18)and non-elderly group(aged <60 years, n=8). General information, surgical osteotomy angle and incidence of complications were compared between the two groups, and the scores of Visual Analogue Scale (VAS) and Knee Injury and Osteoarthritis Outcome Score (KOOS) in both groups were compared before and 1 year after surgery. Results There were no significant differences in sex, Kellgren-Lawrence (K-L) grade, body mass index (BMI), surgical osteotomy angle and incidence rates of complications between the two groups (P>0.01). There were also no significant differences in VAS and KOOS scores between the two groups before and 1 year after surgery (P>0.01), but the VAS score was significantly lower and the KOOS score was significantly higher in both groups after treatment than those before treatment (P<0.01). Conclusions HTO is safe and effective in treating medial compartment knee osteoarthritis in the elderly patients.

Key words: knee osteoarthritis, medial compartment osteoarthritis of knee, high tibial osteotomy, aged

CLC Number:

R 684.3

YANG Zeyu, ZOU Ling, SUN Changhui, LU Jiong, CHEN Yinan, HE Qin, HU Minwei. Effects of high tibial osteotomy on medial compartmental knee osteoarthritis in elderly[J]. Practical Geriatrics, 2024, 38(1): 59-63.

References

[1] SHARMA L. Osteoarthritis of the knee[J]. N Engl J Med, 2021, 384(1): 51-59.
[2] TANG X, WANG S, ZHAN S, et al. The prevalence of symptomatic knee osteoarthritis in china: results from the China Health and Retirement Longitudinal Study[J]. Arthritis Rheumatol, 2016, 68(3): 648-653.
[3] SHARMA L, SONG J, FELSON D T, et al. The role of knee alignment in disease progression and functional decline in knee osteoarthritis[J]. JAMA, 2001, 286(2): 188-195.
[4] VOS T, FLAXMAN A D, NAGHAVI M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010[J]. Lancet, 2012, 380(9859): 2163-2196.
[5] BENZAKOUR T, HEFTI A, LEMSEFFER M, et al. High tibial osteotomy for medial osteoarthritis of the knee: 15 years follow-up[J]. Int Orthop, 2010, 34(2): 209-215.
[6] FU D, LI G, CHEN K, et al. Comparison of high tibial osteotomy and unicompartmental knee arthroplasty in the treatment of unicompartmental osteoarthritis: a meta-analysis[J]. J Arthroplasty, 2013, 28(5): 759-765.
[7] SCHUSTER P, GESSLEIN M, SCHLUMBERGER M, et al. Ten-year results of medial open-wedge high tibial osteotomy and chondral resurfacing in severe medial osteoarthritis and varus malalignment[J]. Am J Sports Med, 2018, 46(6): 1362-1370.
[8] ZHU W, LU W, CUI J, et al. Treatment of tibia avulsion fracture of posterior cruciate ligament with high-strength suture fixation under arthroscopy[J]. Eur J Trauma Emerg Surg, 2017, 43(1): 137-143.
[9] BONASIA D E, DETTONI F, SITO G, et al. Medial opening wedge high tibial osteotomy for medial compartment overload/arthritis in the varus knee: prognostic factors[J]. Am J Sports Med, 2014, 42(3): 690-698.
[10] EKELAND A, NERHUS T K. Editorial commentary: high tibial osteotomy for varus knees with medial osteoarthritis may prevent total knee arthroplasty[J]. Arthroscopy, 2020, 36(2): 544-545.
[11] OTOSHI A, KUMAGAI K, YAMADA S, et al. Return to sports activity after opening wedge high tibial osteotomy in patients aged 70 years and older[J]. J Orthop Surg Res, 2021, 16(1): 576.
[12] DOROFEEV A, TYLLA A, DRESCHER W, et al. Complication analysis after angle-stable CW and OW high tibial osteotomy[J]. Orthopade, 2020, 49(1): 18-25.
[13] STANLEY J C, ROBINSON K G, DEVITT B M, et al. Computer assisted alignment of opening wedge high tibial osteotomy provides limited improvement of radiographic outcomes compared to flouroscopic alignment[J]. Knee, 2016, 23(2): 289-294.
[14] MARTAY J L, PALMER A J, BANGERTER N K, et al. A preliminary modeling investigation into the safe correction zone for high tibial osteotomy[J]. Knee, 2018, 25(2): 286-295.
[15] NAKAMURA R, KOMATSU N, FUJITA K, et al. Appropriate hinge position for prevention of unstable lateral hinge fracture in open wedge high tibial osteotomy[J]. Bone Joint J, 2017, 99-B(10): 1313-1318.
[16] NHA K W, SHIN M J, SUH D W, et al. Uniplane medial opening wedge high tibial osteotomy relative to a biplane osteotomy can reduce the incidence of lateral-hinge fracture[J]. Knee Surg Sports Traumatol Arthrosc, 2020, 28(5): 1436-1444.
[17] DEXEL J, FRITZSCHE H, BEYER F, et al. Open-wedge high tibial osteotomy: incidence of lateral cortex fractures and influence of fixation device on osteotomy healing[J]. Knee Surg Sports Traumatol Arthrosc, 2017, 25(3): 832-837.
[18] BOSTROM A, AMIN A K, MACPHERSON G J, et al. Hinge location and apical drill holes in opening wedge high tibial osteotomy: a finite element analysis[J]. J Orthop Res, 2021, 39(3): 628-636.
[19] CHIEH-SZU YANG J, CHEN C F, LEE O K. Benefits of opposite screw insertion technique in medial open-wedge high tibial osteotomy: a virtual biomechanical study[J]. J Orthop Translat, 2020, 20:31-36.
[20] JUNG W H, TAKEUCHI R, KIM D H, et al. Faster union rate and better clinical outcomes using autologous bone graft after medial opening wedge high tibial osteotomy[J]. Knee Surg Sports Traumatol Arthrosc, 2020, 28(5): 1380-1387.
[21] KIM S J, NGUYEN L T, SEO Y J, et al. Bone healing on serial plain radiographs occurs slowly but adequately after medial opening wedge high tibial osteotomy without bone graft[J]. Knee Surg Sports TraumatolArthrosc, 2022, 30(3): 993-1000.
[22] BELSEY J, DIFFO KAZE A, JOBSON S, et al. Graft materials provide greater static strength to medial opening wedge high tibial osteotomy than when no graft is included[J]. J Exp Orthop, 2019, 6(1): 13.

Effects of high tibial osteotomy on medial compartmental knee osteoarthritis in elderly

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 13

Metrics

Recommended 10

[1]	LIU Yubao, WANG Zhen. Effects of different tourniquet release pattern in elderly patients undergoing total knee arthroplasty [J]. Practical Geriatrics, 2024, 38(1): 18-21.
[2]	ZHANG Ming, CHEN Xi, LIU Yuehong, XIE De, WANG Zhicong, LAN Pingwen, WANG Guanglin. Relationship between red blood cell volume distribution width and prognosis of elderly patients with hip fracture [J]. Practical Geriatrics, 2024, 38(1): 22-27.
[3]	ZHAO Xin, YAN Junwei, YIN Zhaowei, SHI Chen, PAN Shaowei, GU Yanqing, XU Chenyang, YANG Wengbo, WANG Xiao, LIANG Bin. Comparison of intramedullary reduction technique and leverage reduction technique combined with locking plate in the treatment of complex proximal humeral fractures in elderly [J]. Practical Geriatrics, 2024, 38(1): 40-43.
[4]	ZHANG Jia, LIU Xinwei, LIAN Hongyu, LIU Kexin, LI Zitao. Association of hemoglobin concentration with postoperative delirium after hip replacement in elderly patients [J]. Practical Geriatrics, 2024, 38(1): 64-67.
[5]	ZHU Jiao, XIA Lili, XU Minzheng, LIU Ying, WANG Yingxin, YOU Zhengyuan. Analysis of characteristics and influencing factors of fall injury in hospitalized elderly patients [J]. Practical Geriatrics, 2024, 38(1): 81-85.
[6]	LI Jinluan, DU Jun. Effect of ambulation training combined with Buerger movement on improving postprandial hypotension after breakfast in elderly inpatients with hypertension [J]. Practical Geriatrics, 2024, 38(1): 86-89.
[7]	LI Wei, YAN Shao-Jun, LI Jin, ZHU Wei, LIU Wei-Dong, FAN Mei-Hong, ZHANG Yi-Qin, LIN Hua. Effects of bipositive airway pressure noninvasive ventilation treatment on plasma concentration of brain natriuretic peptide for severe pneumonia in elderly patients with heart failure [J]. Practical Geriatrics, 2013, 27(7): 551-.
[8]	HONG Bing, XU Xiao-Wen, YU Wei-Nan, XU Wei, HU Wen. Application of glargine in elderly type 2 diabetic patients during perioperative period [J]. Practical Geriatrics, 2010, 24(2): 132-134.
[9]	ZHENG Juan, LI Xiao-Hong, ZHU Xue-Yun, CHEN Jun, WANG Hong-Xia. Application of microinjection pump in high concentration potassium chloride infusion in the aged with severe hypokalemia [J]. Practical Geriatrics, 2010, 24(2): 141-143.
[10]	CHEN Qing-Ping, HUANG Xue-Cheng, DENG Zi-Qian, ZHANG Feng-Ling, HUANG Ning. Clinical significance of tombstoning of ST segment in elderly patients with acute myocardial infarction [J]. Practical Geriatrics, 2010, 24(2): 147-149.
[11]	Wu Hao, XU Zi-Ban, LI Jian-Guo, JIANG Long-Yuan, HUANG Zi-Tong. Exercise pulmonary function test in evaluation for elderly patients with chronic obstructive pulmonary disease [J]. Practical Geriatrics, 2010, 24(2): 165-167.
[12]	MA Li-Na, TANG Zhe, GUAN Shao-Chen, FANG Xiang-Hua, Wu Xiao-Guang, DIAO Li-Jun, LIU Hong-Jun, SUN Fei. Study on the relationship between familial factors and mental health in elderly people in Beijing [J]. Practical Geriatrics, 2010, 24(2): 168-170.
[13]	CHEN Qian-Yi, HE Xiao-Hua, HU Jian-Wei, BI Yu-Ying. Clinical analysis of 46 elderly patients with grievous hemorrhoidal diseases treated by modified procedure for prolapse and hemorrhoids [J]. Practical Geriatrics, 2010, 24(2): 171-173.