Clinical Analysis Of DTT-HTO In The Treatment Of Simple Medial Compartment Osteoarthritis Of The Knee

Objective:By using the same internal fixator,the clinical effects of the Distal tibial tubercle-high tibial osteotomy(DTT-HTO)and the traditional Open wedge high tibial osteotomy(OWHTO)on the treatment of simple medial ventricular Knee osteoarthritis(KOA)were compared and analyzed.To provide reference for the clinical application of DTT-HTO in the treatment of simple medial compartment type knee osteoarthritis.Methods: Joint surgery to yanbian university affiliated hospital during March2015 to September 2020,44 cases of simple medial compartment type patients with knee osteoarthritis,collect and analysis is divided into two groups according to the operation mode,which USES the tibial tubercle order plane osteotomy for the treatment of patients with 21 cases(single group),the use of high medial tibial open wedge osteotomy of 23 patients with treatment group(double plane),all patients were followed up for at least 6 months after surgery.Two sets of general data were collected to measure the Anatomical medial proximal tibial Angle(AMPTA),the Anatomical femoro tibial Angle(AFTA)and Patellar height(PH)indexes before and after surgery.Lysholm score and Hospital for Special Surgery Knee Score(HSS)score were used to score and record the preoperative and postoperative knee function of patients in the two groups,and the clinical efficacy of the two groups was evaluated by the difference of knee Angle,patella height and score measured between the two groups.Result:1.Within the two groups,the preoperative,postoperative 1 month,postoperative 6month AMPTA Angle was compared,and the paired t test showed statistically significant differences(P<0.05).There was no interaction between the two groups(P>0.05).2.Comparison of AFTA Angle between the two groups before surgery,the first month after surgery,and the sixth month after surgery showed statistically significant differences by paired t-test(P<0.05).There was no interaction between the two groups(P>0.05).3.Comparison of patella height index between the two groups before and 6months after surgery showed no statistically significant difference by t-test in the single plane group(P>0.05),the t-test of biplanar group showed statistically significant difference(P<0.05).Comparison of patella height index between the two groups before and after the 6th month after the surgery,t-test showed that there was no statistically significant difference before the surgery(P>0.05),the t-test at 6 months after the operation showed a statistically significant difference(P<0.05).4.ILysholm scores were pairwise compared between the two groups before surgery,the first month after surgery,and the sixth month after surgery.Paired t-test showed statistically significant differences between the two groups(P<0.05).Comparison of preoperative,postoperative 1 month and postoperative 6month scores between two groups showed no statistical significance by t-test(P>0.05).5.Pairwise comparison of HSS scores before surgery,the first month after surgery,and the sixth month after surgery between the two groups showed statistically significant differences by paired t-test(P<0.05).Comparison of preoperative and postoperative scores between the two groups at the 6th month showed no statistical significance(P>0.05),the t-test of the first menstrual period between the two groups showed statistical significance(P<0.05).Conclusion:1.DTT-HTO can be used in the treatment of simple medial compartment osteoarthritis of the knee,and the same satisfactory correction of the peri-knee Angle as OWHTO can be obtained after surgery,so that the lower limb line can be effectively transferred to the lateral compartment,and there is no obvious loss in the early postoperative period.2.Compared with OWHTO,DTT-HTO can effectively avoid the loss of patella height,maintain the original pressure and movement track of patellofemoral joint,and reduce the wear of patellofemoral joint.3.Although there was no significant difference in subjective Lysholm score between DTT-HTO and OWHTO in the early postoperative period,the same satisfactory effect was obtained.However,because DTT-HTO effectively maintained the patellofemoral height,it had little effect on the training of knee flexion and extension in the early postoperative rehabilitation process,and was superior to OWHTO in the relatively objective early HSS score.