Comparison Of The Postoperative Curative Effects Of The Two Osteotomy Treatments Of Varus Knee

Objective：Guiding the clinical application by comparing the postoperative curativeeffects of two kinds of high tibial osteotomy for varus knee deformity.Methods:Retrospective analysis of hospitalized patients undergoing varus kneeosteotomy operation inDepartment of orthopedics, China-Japan Union Hospitalof Jilin University from2005March to2012October, and following up in24cases (38knees) patients as the research object. According to the differentmethods of operation, they were divided into two groups: group A undergoinghigh tibial lateral closing wedge osteotomy plate fixation group, group Bundergoing high tibial medial opening wedge osteotomy and bone graftingorthopedic plate fixation group, group A including18cases (28knees), Bgroup6cases (10knees). Record the preoperative and postoperative HSS scoreof knee joint, knee medial gap distance, femoral and tibial angle (FTA), posterior tibial slope angle, height of patella(the ratio of Insall-Salvati) fo thetwo groups, and the data were statistically analyzed using SPSS19.0software.Results:1.Comparison of differences in the preoperative and postoperative of theHSS score of knee joint, knee medial gap distance, tibiofemoral angle (FTA),posterior tibial slope angle, height of patella (Insall-Salvati ratio) of A group(i.e. high tibial lateral closing wedge osteotomy and internal fixation group).The differences were statistically significant, by checking for non-normaldistribution, using a paired T test, P<0.05, indicating that the femoral and tibialangle, medial knee clearance, posterior tibial slope, patellar height(Insall-Salvati ratio) of preoperative and postoperative have differences.2. Comparison of differences in the preoperative and postoperative of theHSS score of knee joint, knee medial gap distance, tibiofemoral angle (FTA),posterior tibial slope angle, height of patella (Insall-Salvati ratio) of B group(i.e. high tibial lateral closing wedge osteotomy and internal fixation group).The differences were statistically significant, by indicating normal distribution,using a paired T test, P<0.05, indicating that the femoral and tibial angle, medial knee clearance, posterior tibial slope, patellar height (Insall-Salvatiratio) of preoperative and postoperative differ.3.Comparing the postoperative differences between A group and Bgroup, indicated that thedifferences in femoral and tibial angle, medial kneeclearance and HSS of the two groups isnormal distribution, using T test,P>0.05, meaning the difference was not statistically significant.4. Comparing changes between A group and B group postoperative tibialretroversion angle, the angle tilt test rate is normal distribution, using T test,P<0.05, the differences were statistically significant.5.Comparing changes between A group and B group of the patellar heightrate(the ratio of Insall-Salvati,rate),conclusion is that the patellar heightchanges are normal distribution, using T test, P<0.05, have significantdifference.Conclusion:1.These two kinds of tibial osteotomy surgery have certain effects onimproving the knee joint line of force and the function of knee joints, and theshort term curative effect is good. 2.High tibial lateral closing wedge osteotomy fixation has short operationtime and simple operation procedure, yet with potential risks such as the needto truncate fibula, a higher risk of injury of common peroneal nerve and bloodvessel, and decreasing the tibial retroversion and the decline of patella.3.High tibial medial opening wedge osteotomy and bone graftingorthopedic fixation has short operation time, simple operation, and does notneed a fibular osteotomy, besides, the body is less traumatic. Operativeprocedure can be adjusted according to the need of corrective angle, offeringthe obvious advantage of protecting common peroneal nerve and vascularinjury, but there is high risk of delayed union or nonunion of patella fracture,indicating the need of further observation on the clinical effect for long-term.4.The selection of the optimum operation plan to patients with knee varusdeformity needs strict preoperative evaluation.