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Title: [Evaluation of the efficacy of medial open wedge high tibial osteotomy combined with anterior cruciate ligament reconstruction in the treatment of varus knee osteoarthritis with anterior cruciate ligament injury].
Author: Zhu JW, Chen DS, Lei L, Wang TF, Duan GQ, Gou Y, Zhao JW.
Journal: Zhonghua Yi Xue Za Zhi; 2024 May 07; 104(17):1481-1485. PubMed ID: 38706054.
Abstract:
Objective: To evaluate the efficacy of medial open wedge high tibial osteotomy (MOWHTO) combined with anterior cruciate ligament (ACL) reconstruction in the treatment of varus knee osteoarthritis (OA) with ACL injury. Methods: A follow-up study. The study retrospectively analyzed the patients underwent MOWHTO combined with ACL reconstruction for treatment of varus knee OA with ACL injury in Tianjin Hospital between April 2018 and September 2022. The preoperative and postoperative posterior slope angle (PSA), hip-knee-ankle angle (HKA), visual analog scale (VAS) pain scores, Lysholm score, International Knee Documentation Committee (IKDC) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and Tegner score were compared. The follow-up indicators were recorded at 6 weeks, 3 months and 1 year after operation, and the complications were recorded. Results: The study included 32 patients (23 males, 9 females) with a mean age of (50.7±8.4) years. The mean follow-up time was (21.2±4.8) months. PSA increased from 9.2°±1.8° preoperatively to 11.1°±2.4° postoperatively, and HKA increased from 168.7°±2.2° to 181.5°±2.2° (both P<0.01). The indicators such as VAS score (6.8±1.1 vs 1.8±0.4), Lysholm score (52.6±7.1 vs 82.0±6.4), IKDC score (64.7±6.2 vs 80.3±10.0), WOMAC score (51.8±6.3 vs 81.8±6.5), and Tegner score (1.9±0.6 vs 5.0±1.0) were all improved after the operation (all P<0.01). Complications occurred in 5 patients (15.6%), including hematomas, sensory abnormalities, intermuscular vein thrombosis and correction angle loss. Conclusion: MOWHTO combined with ACL reconstruction is a safe and effective approach for the treatment of varus knee OA with ACL injury. 目的： 评估内侧开放楔形胫骨高位截骨术（MOWHTO）联合前交叉韧带（ACL）重建治疗膝内翻骨关节炎（OA）伴ACL损伤的临床效果。 方法： 随访研究。回顾性分析2018年4月至2022年9月在天津市天津医院接受MOWHTO联合ACL重建治疗膝内翻OA伴ACL损伤患者的临床资料，比较术前和术后患者胫骨后倾角（PSA）、髋-膝-踝角（HKA）、疼痛视觉模拟评分（VAS）、膝关节功能评分包括Lysholm评分、国际膝关节文献委员会（IKDC）评分、改良版西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分和Tegner评分变化。术后6周、3个月和1年随访各指标情况并记录并发症发生情况。 结果： 本研究共纳入32例患者，其中男23例，女9例，年龄为（50.7±8.4）岁，随访时间（21.2±4.8）个月。患者PSA由术前9.2°±1.8°增至术后11.1°±2.4°，HKA由术前168.7°±2.2°增至术后181.5°±2.2°（均P<0.01）。患者术前术后的疼痛VAS评分［（6.8±1.1）分比（1.8±0.4）分］、Lysholm评分［（52.6±7.1）分比（82.0±6.4）分］、IKDC评分［（64.7±6.2）分比（80.3±10.0）分］、WOMAC评分［（51.8±6.3）分比（81.8±6.5）分］、Tegner评分［（1.9±0.6）分比（5.0±1.0）分］均有改善，差异均有统计学意义（均P<0.01），临床疗效满意。5例患者出现并发症（15.6%），包括血肿、神经感觉异常、肌间静脉血栓、矫正角度丢失。 结论： MOWHTO联合ACL重建是治疗膝内翻OA伴ACL损伤的安全、有效的手段。.

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