Hort-Term Curative Effect Nanlysisis Of High Tibial Osteotmy For The Treatment On Medial Compartment Knee Osteoarthritis

The research backgroundAlong with our country population aging degree of accelerating structure, the incidence of osteoarthritis (OA) showing a rising trend year by year, the serious influence the patient’s quality of work and daily life.OA is a common chronic joint disease, OA in weight-bearing bigger of the knee, hip and spine, in areas such as the joint with knee is common. Knee osteoarthritis (KOA), KOA mainly occurs in the elderly population is more see,50 to 60 years old, about 80%,60-70, about 90%, about 100% above the 70-year-old has radiographic pathology, but only about 18% of clinical symptoms.KOA lesions are mainly knee joint cartilage of primary or secondary degeneration, subchondral osteophyte hyperplasia, structure disorder, which happens a chronic degenerative disease of the knee joint dysfunction. KOA early lesions are usually limited to knee medial compartment, because the knee joint is a normal 5 ° valgus Angle 8 °, knee joint from 60% to 75% of the weight of the load is through the medial part of the knee joint, knee joint is 25%-25% of the load by the outside, the load is greater than the lateral compartment knee medial compartment, so the long-term development can lead to a varus deformity of knee joint, thus knee medial compartment lesions of knee arthritis is rare. Knee medial compartment degeneration occurs, easy cause knee varus deformity, and knee varus deformity cause changes in the lower limb power line, resulted in the pathological process of knee joint osteoarthritis progression, a vicious cycle.KOA patients often when young, severe joint pain, conservative treatment the effect not beautiful, but the line of total knee arthroplasty (TKA), patient, young, mobility of postoperative easily become loose, wear and tear, likely secondary repair surgery.Expect a reserved joints treatment.High tibia osteotomy (HTO) by bone cutting operation and change the distribution of the lower extremities abnormal line of force, correct the knee medial tibial articular surfaces excessive load, make room high stress "uninstall" between the lesions, thus improve the biomechanics of the knee joint environment, make the inside of the articular cartilage repair rebirth.And get inside the bones of bone cutting stress drop, improve blood circulation effectively, so as to eliminate or relieve knee pain, satisfy its delay or artificial joint replacement. HTO is mainly to delay the progress of the knee joint degeneration, restore the normal activity of the knee joint, and improve the patients quality of life of purpose. Since 1958, when Jackson first puts forward the tibia bone cutting, high HTO art has always been considered treatment knee medial compartment osteoarthritis very valuable way of surgical treatment.ObjiectiveTo explore high tibia bone cutting (HTO) in the treatment of knee medial compartment osteoarthritis in clinical application and short-term curative effect evaluation analysis.MethodsChoose between January 2015 and January 2015 in qilu hospital of shandong university, line 2 ward high tibia bone bone cutting of 20 patients (26), including 4 cases of male, female 16 cases. Preoperative and postoperative used The The American knee society (AKS)、The Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC) and Visual analogue scale (VAS), before and after knee positive side and The lower limb length standing X-ray examination, and preoperative and postoperative Femorotibial Angle(FTA), and Medial proximal tibial Angle(MPTA) such as indicators for The treatment of tibial bone cutting high knee Medial compartment Osteoarthritis curative effect evaluation and analysis.ResultsThis group of 20 patients received follow-up,3-12 months follow-up time, postoperative patients with knee joint pain, lower limb power line were significantly improved. Superficial infection,1 case of incision, and the rest recovered well and no other complications. For the last follow-up postoperatively in patients with knee joint AKS score (84.6±5.1), compared with preoperative increased (15.5-3.0) points, WOMAC score of (50.4 ± 11.3), compared with preoperative improved (55.5 ± 7.6), (2.7-0.9) for VAS score points, compared with preoperative reduced (4.1-0.7), postoperative standing over double lower limbs is a X-ray measurement of MPTA (88.2 ±1.5) °,the preoperative corrected (6.4 ±3.4) °, FTA (172.6±2.8) °, the preoperative corrected (14.5±4.9) °.Patients with postoperative AKS score, WOMAC score, VAS score, MPTA and FTA Angle compared with preoperative, the difference was statistically significant (P< 0.05).ConclusionHigh tibia bone cutting bone cutting operation to change the distribution of the lower extremities abnormal line of force, correcting knee medial tibial joint excessive load, eliminate or relieve knee pain and delay the progress of knee joint degeneration, restore the normal activity of the knee joint, improve patient quality of life, can delay or exempt from artificial joint replacement, short-term gain good clinical effect, long-term effect remains to be further tracking and follow-up research.