股骨胫骨双截骨治疗严重膝内翻畸形的手术策略及中期临床结果

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Abstract Objective To retrospective evaluate the clinical and radiologic results of double level osteotomy(DLO) for osteoarthritis knees with severe varus deformity and mid-term results.Methods The patients in Beijing Jishuitan Hospital between 2016-2018 who underwent DLO for osteoarthritis knees with severe varus deformity were retrospectively studied.21 patients，including 5 males and 16 females were ultimately enrolled.The age ranged form 25 to 68，with an average age of (47.7±11.8)years.All patients underwent radiological assessment.In the radiological assessment，the following parameters were measured on fulllength weightbearing radiographs both pre and postoperatively：femorotibial angle(FTA)，lateral distal femoral angle(LDFA)，medial proximal tibial angle(MPTA)，and jointline convergence angle(JLCA).In addition，we shared the experience of preoperative planning using Miniacci methods and surgical strategy.We also analyzed the reasons and results of intro-operative and post-operative complications.Clinical results were evaluated using the Oxford knee score(OKS)e.Results The preoperative FTA，LDFA，MPTA，and JLCA values averaged (162.1±7.6)° varus，(79.5±6.2)°，(98.1±7.4)°，and (2.1±2.7)°，respectively.The postoperative FTA，LDFA，MPTA，and JLCA values averaged (178.2±5.6)° varus，(89.5±2.6)°，(90.8±5.2)°，and (1.5±1.3)°，respectively.All of the radiological parameters significantly improved and corrected to the values within normal range(P＜0.05).All osteotomy sites were fixed with Tomofix plate，and healed well even with hinge fracture.All patients were followed up for (5±1)years.The OKS was (44±3) in the last phone interview.Conclusion The DLO technique is a valuable surgical technique accomplishing restoration of physiologic knee joint alignment and orientation with significant improvement.The bone healing rate was 100% even with hinge fracture using single plate fixation because all osteotomy sites were fixed with Tomofix locking plate system which is a rigid fixation.

Key words： double level osteotomy varus knee high tibial osteotomy Tomofix osteoarthritis

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	Liu Jian
	Wang Xingshan
	Liu Yuan
	Huang Ye

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Liu Jian,Wang Xingshan,Liu Yuan, et al. The Strategy of Double Level Osteotomy for Osteoarthritis Knees with Severe Varus Deformity And The Mid-Term Results[J]. sygkzz, 2022, 28(10): 865-.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2022/V28/I10/865

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[1]	. [J]. sygkzz, 2022, 28(9): 837-.