| Objective:To analyze the imaging indexes of full-length radiographs of lower limbs and standard knee radiographs in weight-bearing position,and to explore the clinical efficacy of Open wedge high tibial osteotomy(OWHTO)for medial compartment knee osteoarthritis and knee varus in elderly people.Materials and methods:The clinical and follow-up data of 136 elderly patients with osteoarthritis who were diagnosed and treated with open wedge high tibial osteotomy in Foshan Hospital of Traditional Chinese Medicine from September 2020 to March 2022 were retrospectively analyzed.Preoperative and postoperative 1 week,3 months after operation and postoperative 6 months with a double length of the lower limb X-ray films and the standard knee X ray film,evaluation of preoperative knee osteoarthritis grading,K/L in lower limb length is measured on a piece of the lower extremities of force ratio,hip,knee ankle Angle(HKA),on the knee joint is a piece of measuring femoral tibial Angle(FTA)。The Hospital for Special Surgery(HSS)knee evaluation system was used to evaluate the surgical outcome before operation and at 3 and 6 months after operation.Visual analogue scale(VAS)was used to evaluate knee pain.The knee range of motion(ROM)and Lysholm knee function score were compared before operation,3 months after operation,and 6 months after operation.For X-ray scanning,GE656 Puls,u DR 780 i and Siemens Ysio were used,with focal film distances of 180 cm and 100 cm,tube voltage of 70 k Vp and tube current of 25 m As.Full-length X-ray films of both lower limbs were automatically assembled after shooting,and then transmitted to PACS workstation for reading.Results:1.Preoperative K/L grading of medial compartment osteoarthritis of the knee:22cases of grade Ⅱ,60 cases of grade Ⅲ,54 cases of grade Ⅳ.2.Lower extremity line ratio,hip knee ankle Angle(HKA)and FTA: the average lower extremity line ratio before operation,1 week after operation,3 months after operation and 6 months after operation were(15.45±12.82)%,(62.09±12.45)%,(60.52±10.76)% and(59.87±10.91)%,respectively.The average HKA was(172.55±3.55)°,(184.34±4.45)°,(183.76±4.82)° and(183.32±4.25)° before operation,1week,3 months and 6 months after operation,respectively.The mean FTA before operation,1 week after operation,3 months after operation and 6 months after operation were(182.35±2.39)°,(169.54±3.62)°,(170.41±3.03)°,(170.98±4.38)°.There were significant differences in lower limb line ratio,HKA and FTA before and after operation(P<0.05),there were no genu varus patients at 3 and 6 months after operation.3.Clinical scoring scale: HSS score showed a significant increase trend after surgery,and HSS score at 6 months after surgery was significantly higher than that before surgery and 3 months after surgery.VAS score,knee range of motion and Lysholm score: The VAS score of patients before operation,3 months and 6 months after operation showed a significant trend of decrease,while the knee range of motion,Lysholm score showed a significant trend of increase(P<0.05).Conclusion:X-ray examination plays an important role in the diagnosis of medial compartment osteoarthritis of the knee,knee varus,preoperative planning and postoperative evaluation of OWHTO.Open wedge-shaped high tibial osteotomy is effective in the treatment of medial compartment osteoarthritis of knee in elderly people.It can significantly correct genu varus,relieve pain,and improve knee function and quality of life. |
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