关键词: 截骨术, 内翻膝骨关节炎, 胫骨, 临床疗效

Abstract: Objective To observe the clinical effect of open wedge high tibial osteotomy(OWHTO) in the treatment of varus knee osteoarthritis and summarize treatment experience. Method 19 patients with varus knee osteoarthritis and treated by OWHTO in Wuhan Third Hospital between September 2018 and January 2021 were analyzed retrospectively.HSS score and VAS were used to evaluate the improvement of knee function and pain before and after operation.The correction effect of the surgery was evaluated by measuring MPTA and WBL.The scores and measured indicators at three time points of preoperation,3 months and 12 months after operation were compared.Results All patients were followed up for an average of(12±3) months.No internal fixation failure occurred during the follow-up.The HSS score at 3 months and 12 months after operation was significantly higher than that before operation(78.58±10.34，86.74±7.08，59.89±8.33，F＝47.66，P＜0.01),and the VAS at 3 months and 12 months after operation was significant lower than that before operation(2.47±0.61，1.32±0.58，6.47±0.77，F＝318.70，P＜0.01).For the imaging examination indexes,MPTA[(90.68±1.00)°，(90.37±1.01)°] and WBL[(60.53±1.73)%，(60.26±1.72)%] were improved and varus deformity was corrected at 3 month and 12 month after operation(P＜0.01).After 12 months of follow-up,the range of motion was significantly improved[(128.84±9.90 ）°vs (112.42±12.92)°，t=4.58，P＜0.01].Two cases of incision delayed healing,and the other incisions were primary healing without incision infection and bone infection.One patient had delayed union at the osteotomy site,and the bone union time was 6 months after operation.Intermuscular venous thrombosis of leg was occurred in two cases after operation and they recovered completely after comprehensive symptomatic treatment. Conclusion OWHTO could relieve joint pain and improve joint function by correcting the force line of lower limbs.It has excellent clinical effect on knee osteoarthritis with tibial varus,but it is necessary to grasp the surgical indications and pay attention to the details of the operation.

Key words: osteotomy, varus knee osteoarthritis, tibal, clinical effect