胫骨高位外翻截骨术后7 ~ 19年内侧室状骨关节炎膝关节软骨下骨硬化减少。

Shigenori Takahashi, Koshino Tomihisa, Tomoyuki Saito
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引用次数: 0

摘要

应用骨密度仪对40例高胫骨外翻截骨术矫正内翻畸形的55例内侧室状骨关节炎膝关节进行平片测量软骨下骨硬化情况。计算膝关节内侧骨硬化值与外侧骨硬化值之比(内侧/外侧比)作为参数。在股骨和胫骨的参考点截骨后三年内,骨硬化的内侧/外侧比例迅速下降。截骨后7 ~ 19年,有16例站立股胫角(FTA)小于168度(解剖外翻角为12度)的膝关节比例下降。这被解释为在过度矫正内翻畸形后,内侧髁的骨硬化比外侧髁的骨硬化减少。在高位胫骨截骨术后7年以上的病例中,通过计算内侧/外侧比值与站立股胫角表示的术后肢体直度之间的正直线回归,相关系数(gamma)为0.295 (p < 0.01)。
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Decrease of osteosclerosis in subchondral bone of medial compartmental osteoarthritic knee seven to nineteen years after high tibial valgus osteotomy.

Osteosclerosis of the subchondral bone was measured by densitometer on plain radiographs in 55 medial compartmental osteoarthritic knees of 40 patients who were treated with high tibial valgus osteotomy for correction of varus deformity. The ratio of the osteosclerosis value of the medial side of the knee to that of the lateral side (Medial/Lateral ratio) was calculated and used as a parameter. The Medial/Lateral ratio of osteosclerosis decreased rapidly within three years after osteotomy at the reference points of the femur and the tibia. Even 7 to 19 years after osteotomy, a decrease of the ratio was noted in 16 knees with a standing femorotibial angle (FTA) less than 168 degrees (12 degrees of anatomical valgus angulation). This was interpreted to mean that osteosclerosis of the medial condyle decreased compared with that of the lateral condyle after overcorrection of varus deformity. In the cases of more than 7 years after high tibial osteotomy, a positive straight regression line was drawn by calculation between Medial/Lateral ratio and postoperative limb alignment expressed by standing femorotibial angle, with coefficient of correlation (gamma) of 0.295 (p < 0.01).

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