单平面与双平面截骨对OWHTO术后胫骨后倾角的影响

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Abstract Objective To evaluate the effect of uniplanar versus biplanar medial open-wedge high tibialosteotomy（OWHTO） on posterior tibial slope (PTS) following treatment of varus gonarthrosis with medial opening-wedge high tibial osteotomy.Methods This study included 23 cases (29 knees) with medial compartment knee osteoarthritis treated with OWHTO，of which 8 cases (10 knees) were treated with uniplanar HTO (uniplanar HTO group)，15 cases (19 knees) were treated with biplanar HTO (biplanar HTO group)，both group were fixed with Tomofix plate.The imaging evaluation included the preoperative mechanical medial proximal tibial angle (mMPTA)，mechanical lateral distal femoral angle，mLDFA (mLDFA)，PTS，and the anatomical femorotibial Angle (aFTA).Postoperative mMPTA，PTS and aFTA were also measured.The average follow-up was (1.30±0.54)years (0.6~2.0 years).Results There were no significant difference between two groups about preoperative mMPTA，mLDFA，FTA.PTS of uniplanar HTO group was larger than biplanar HTO group，(14.56±4.55)° and (9.87±2.63)° respectively.MMPTA was significantly increased in both groups，whereas the aFTA decreased with significant difference.The postoperative PTS of uniplanar HTO group decreased compared with that of pre-operation with no significant difference.The PTS of biplanar HTO group increased compared with that of pre-operation with significant difference.Conclusion Both uniplanar and biplanar HTO can correct varus gonarthrosis，but biplanar HTO may result in increasing of PTS more easily，the effect of uniplanar HTO on PTS is less than biplanar HTO.

Key words： uniplanar high tibialosteotomy biplanar high tibialosteotomy posterior tibial slope knee osteoarthritis

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