开刃胫骨高位截骨术后长期病例中髌股关节骨关节炎的发生:髌股关节骨关节炎与非髌股关节骨关节炎:基于患者站立类型评估的症状差异

IF 1.1 4区 医学 Q3 ORTHOPEDICS Indian Journal of Orthopaedics Pub Date : 2024-08-29 DOI:10.1007/s43465-024-01250-z
Noriyuki Gomi, Hiroaki Muramoto, Yusuke Kataoka
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引用次数: 0

摘要

目的 研究髌股关节(PFJ)骨关节炎(OA)及其症状在开楔胫骨高位截骨术(OWHTO)长期疗程中的发生频率。平均术后时间为 127.5 ± 19.5 个月,91 个关节和 22 个关节出现了 OA 和骨坏死(ON)。在X光评估中,我们分析了股胫骨站立角(FTA)、机械轴百分比(%MA)、卡顿-德尚指数(CDI)、髌骨倾斜角(TA)、髌骨外侧移位(LPS)和PFJ间隙宽度(内侧[MJS]和外侧[LJS])。使用特殊外科医院髌骨评分(HSS-PS)和膝关节损伤与骨关节炎结果评分髌骨-股骨分量表(KOOS-PF)评估与PFJ相关的症状。统计分析采用配对和非配对 t 检验,风险率小于 1%,则判定为显著风险。术前 %MA 从 20.8 侧降至最终随访时的 66.0。TA和LPS值与手术前相比明显下降,直至钢板移除。MJS和LJS明显下降,14例患者出现了关节间隙< 3 mm的OA。然而,有无 OA 组的 HSS-PS 和 KOOS-PF 评分无明显差异。
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Occurrence of Patellofemoral Joint Osteoarthritis in Long-Term Postoperative Cases of Open-Wedge High Tibial Osteotomy: Differences in Symptoms Based on Patient-Standing Type Evaluation with and Without Patellofemoral Joint Osteoarthritis

Purpose

To examine the frequency of patellofemoral joint (PFJ) osteoarthritis (OA) and its symptoms in the long-term course of open-wedge high tibial osteotomy (OWHTO).

Methods

We analyzed 113 joints of 91 patients. OA and osteonecrosis (ON) developed in 91 and 22 joints, after an average postoperative period of 127.5 ± 19.5 months. For X-ray evaluation, the standing femorotibial angle (FTA), % mechanical axis (%MA), Caton–Deschamps index (CDI), patellar tilt angle (TA), lateral patellar shift (LPS), and PFJ space width (medial [MJS] and lateral [LJS]) were analyzed. PFJ-associated symptoms were evaluated using the hospital for special surgery patellar score (HSS-PS) and knee injury and osteoarthritis outcome score patellofemoral subscale (KOOS-PF). Statistical analysis was performed with paired and unpaired t tests, and a risk rate of less than 1% was significantly judged.

Results

Preoperative FTA and CDI decreased from 180.8° to 170.0° and 0.88 to 0.70 at the final follow-up. Preoperative %MA lateralized from 20.8 to 66.0 at the final follow-up. TA and LPS values decreased significantly compared with before surgery until plate removal. The MJS and LJS significantly decreased, and OA with a joint space < 3 mm occurred in 14 cases. However, HSS-PS and KOOS-PF scores were not significantly different between the groups with and without OA.

Conclusion

PFJ OA occurred in 12.4% cases in the long-term postoperative course of OWHTO; however, no symptomatic difference was found in the group with or without OA.

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来源期刊
CiteScore
1.80
自引率
0.00%
发文量
185
审稿时长
9 months
期刊介绍: IJO welcomes articles that contribute to Orthopaedic knowledge from India and overseas. We publish articles dealing with clinical orthopaedics and basic research in orthopaedic surgery. Articles are accepted only for exclusive publication in the Indian Journal of Orthopaedics. Previously published articles, articles which are in peer-reviewed electronic publications in other journals, are not accepted by the Journal. Published articles and illustrations become the property of the Journal. The copyright remains with the journal. Studies must be carried out in accordance with World Medical Association Declaration of Helsinki.
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