| Background: with the development of knee preservation concept,open osteotomy and orthopaedic surgery of the medial tibial high position has been widely used as a knee preservation treatment method to delay total knee replacement,and has become the most important link.Currently,the most popular osteotomy methods are the ascending high biplane nodule of the medial tibia and the descending high biplane of the medial tibia,both of which have been proved to be able to correct the lower limb line of force,and have achieved satisfactory clinical efficacy after surgery.Although high tibial osteotomy can delay total knee arthroplasty,total knee arthroplasty as a end-stage treatment is still the consensus of all scholars.Therefore,the original anatomical shape of the knee joint should be retained as much as possible when performing high tibial osteotomy to avoid increasing the difficulty of total knee replacement in the future.Objective: to investigate the clinical effect of open osteotomy of the superior medial biplane tibial tubercle and open osteotomy of the superior medial biplane tibial tubercle.Methods: retrospective analysis of bone outside a branch in January2016-2019 between 34 cases of knee varus deformity caused by knee osteoarthritis patients treated tibial medial high cut,according to the operation method is divided into high tibial medial biplanar nodules uplink open group and high tibial medial biplanar nodules of bone cutting downward open bone cutting group.Preoperative and postoperative HSS knee function score,tibiofemoral Angle,patella height and tibial plateau reclinal Angle were used as the observation indexes.The data results were then input into SPSS22.0 software for statistical analysis.When the results showed P<0.05,the data gap was considered statistically significant.Results: group A(i.e.,biplanar high tibial medial tubercle uplink open cut bone group)postoperative HSS scoring,tibial Angle,patellar height ratio(i.e.Insall-Salvati)and Angle difference after tibial platform,by test data into normal distribution,the paired t test,P < 0.05 difference have statistical significance,think HSS score and shank Angle change there are differences between the preoperative surgery;The difference of P>0.05 was not statistically significant,suggesting that there was no difference in patella height(i.e.,insall-salvati ratio)and tibial plateau posterior obliquity before and after surgery.Comparison of group B(i.e.,biplanar high tibial medial tubercle uplink open cut bone)postoperative HSS scoring,tibial Angle,patellar height and Angle difference after tibial platform,by test data into normal distribution,USES the paired t test,P <0.05 difference have statisticalsignificance,think there are differences between the preoperative postoperative HSS score and tibial Angle change;The difference of P>0.05 was not statistically significant,suggesting that there was no difference in patella height and tibial plateau inclination before and after surgery.Postoperative HSS score compare group A or group B,shank Angle changes,patellar height and Angle change after tibial platform,after into normal distribution test,paired t-test,there was no statistically significant difference(P > 0.05,don’t think postoperative HSS score,group A and group B after tibial Angle,tibia platform Angle change is statistically significant,P < 0.05,think patellar height change statistically significant.Conclusion: both of the two surgical methods(i.e.,biplane medial tibial nodules ascending and descending open osteotomy)improved the knee function and corrected the lower limb strength line.High tibial medial tubercle uplink patella bone cutting group changed the height,the tibial medial tubercle downward patella bone cutting group did not change height,for Angle changes after tibial platform,two kinds of operation method and no difference,so we think the bi-planar high tibial medial tubercle downward open bone cutting can retain more preoperative patellar height. |
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