| Objective(s):Focusing on the treatment of knee osteoarthritis(KOA)to explore the difference in efficacy of open wedge high tibial osteotomy(OWHTO)in the treatment of KOA under different target lower limb alignment Settings,and to provide optimal treatment options for the clinic.Methods:A prospective cohort study was conducted to analyze 50 cases of medial KOA treated by OWHTO in our department from June 2019 to June 2021(25males and 25 females,mean age group A 57 years,group B 58 years,left side 25,right side 25).Patients were grouped according to the size of medial space on preoperative knee X-ray.When the medial space of the knee joint is greater than 3mm,Weight Bearing Line(WBL)is adjusted to 50%-60%,set as A1 group,WBL is adjusted to 60%-65%,set as A2 group,when the medial space of the knee joint is less than or equal to 3mm,WBL is adjusted to 50%-60%,set as group B1,WBL is adjusted to 60%-65% and set as group B2.Pain scores Visual Analogue Scale(VAS)And the Westem Ontario And Mc Master Universities(WOMAC)of the four groups were compared before surgery,1 month,3 months,6 months and 12 months after surgery Osteoarthritis Index,preoperative and postoperative knee Magnetic Resonance Imaging examination,preoperative arthroscopy for the first time to investigate the knee cartilage injury,postoperative arthroscopy for the second time to investigate the knee cartilage regeneration 12 months later,follow-up 12 months later,A total of 50 patients were enrolled,of which 2 were lost to follow-up.The number of patients who participated in the final evaluation of efficacy was 48,and the total shedding rate was 4%.Results: The results of independent sample T-test showed that there were no significant differences in VAS and WOMAC values of group A1,A2,B1 and B2 before surgery.When the medial knee space was greater than 3mm,the VAS and WOMAC values of group A1 were lower than those of group A2 in 1,3,6 and 12 months after surgery.When the medial knee space was less than or equal to 3mm,The VAS and WOMAC values of group B1 were higher than those of group B2 at 1,3,6and 12 months after surgery,and there were significant differences in VAS and WOMAC values of groups A1,A2,B1 and B2 at 1,3,6 and 12 months after surgery.Chi-square test showed that there was no significant difference in the preoperative Recht grading of MRI cartilage injury in groups A1,A2,B1 and B2 and the Outerbridge grading of knee cartilage injury under the microscope.There was a significant difference in the Recht grade of knee MRI cartilage regeneration between group A1 and group A2 12 months after surgery((?) 2=7.567,P=0.023),and the therapeutic effect of group A1 was better than that of group A2.There was a significant difference in the Recht grade of knee MRI cartilage regeneration between group B1 and B2 12 months after surgery((?)2=6.329,P=0.042),and the therapeutic effect of group B2 was better than that of group B1.The Outerbridge grading of arthroscopic cartilage regeneration in group A1 and Group A2 at 12 months after surgery was significantly different((?)2=7.421,P=0.024),and the therapeutic effect of group A1 was better than that of group A2.There was a significant difference in the Outerbridge grading of arthroscopic cartilage regeneration between group B1 and B212 months after surgery((?)2=7.000,P=0.030),and the therapeutic effect of group B2 was better than that of group B1..Conclusion(s):The results of this study showed that for patients with medial knee space greater than 3mm,WBL should be set in the range of 50%-60%.For patients with medial knee space less than or equal to 3mm,WBL should be set in the range of 60%-65%,and the long-term efficacy should be further long-term follow-up studies in the future。... |
PDF Full Text Request