胫骨高位截骨治疗膝关节骨性关节炎

目的：总结外侧闭合楔形胫骨高位截骨术（high tibial osteotomy，HTO）治疗膝关节单间室骨性关节炎引起的关节疼痛临床应用结果。方法：应用外侧闭合楔形HTO治疗9例（男3例，女6例）伴内翻畸形的膝关节单间室骨性关节炎。年龄52～58岁，平均56岁。术中显露胫腓关节近侧，切开前侧关节囊，用骨锯或骨刀去除外侧楔形骨块，闭合截骨处缺损后用“U”形钉固定。结果：手术顺利，无手术并发症，经2-5、5年（平均3．5年）随访，按膝关节骨性关节炎疗效评定标准：优5例，良好3例，尚可1例。结论：外侧闲合楔形HTO是治疗膝关节单间室骨性关节炎引起关节疼痛的有效手术方法，但不适用于年龄过大的患者（〉60岁）。

High tibial osteotomy for the treatment of osteoarthritis of the knee

Objective: To summarize clinical application of the high tibial osteatomy(HTO)with lateral closing-wedge f- or the treatment of pain of unicompartmental osteoarthritis of the knee. Methods: From February 2000 to February 2004,9 patients(3 males and 6 females,ranging in age from 52 to 58 years,with an average of 56 years)with unicompartmental osteoarthritis of the knee treated by HTO with lateral closing-wedge. The proximal tibiofibular joint was exposed,the anterior part of the capsule was incised,and to remove a laterally based wedge with saw cuts and osteotomes. Stepped staples were used for the fixation of tibial osteotomies after closing the defect of osteotomy. Results: The operative course was uneventful. There were no complications after operation. The postoperative follow-up period ranged from 2 to 5.5 years(mean,3.5 years). The resul- ts were evaluated with functional assessment criterion of the osteoarthritis of the knee,among the 9 cases,excellent was in 5 cases,good in 3 cases,fair in 1 case. Conclusion: HTO with lateral closing-wedge is an effective operative method for the treatment of pain of unicompartmental osteoarthritis of the knee,but except for older patients over 60 years.