Short-term Clinical Effect Of High Tibial Osteotomy Combined With Arthroscopy In The Treatment Of Medial Knee Osteoarthritis

Objective:To retrospectively study the short-term clinical effects of high tibial osteotomy(HTO)combined with arthroscopy in the treatment of medial kneeosteoarthritis,KOA).Methods:To retrospectively study 32 patients with medial knee osteoarthritis treated by HTO combined with arthroscopy from April 2017 to December 2018.There were 12 males and 20 females,aged 47-62 years with an average of(55.66 4.84)years.The injury degree of medial compartment cartilage was observed and recorded under arthroscope,and the planned axis was designed according to it.At the same time,intra-articular diseases such as meniscus injury,free body and popliteal cyst should be treated.Hospital for special surgery knee(HSS)score,Lysholm knee score and Visual Analogue Scale(VAS)were recorded before operation and at the last follow-up.Hip-knee-ankle(HKA)angle and medial proximal tibial angle(MPTA)were recorded before and after operation.The above results were statistically analyzed.The patients underwent a second-look arthroscopic evaluation of the articular cartilage and observe cartilage regeneration.Results:All patients were followed up for 10-28 months,with an average of(19.03±6.17)months.HSS score was(63.44±4.12)before operation and(88.63±3.32)at the last follow-up.Lysholm score was(55.25±4.43)before operation and(93.59±2.80)at the last follow-up.VAS score was(6.31±1.5)before operation and(2.19±1.36)at the last follow-up.HKA was(171.29±1.78)° preoperatively and(183.60±1.35)° postoperatively.MPTA was(78.97±1.40)° preoperatively and(90.81±1.73)° postoperatively.All the above-mentioned postoperative results showed statistically significant difference compared with preoperative results(p < 0.05).The three patients underwent a second-look arthroscopic and cartilage regeneration was found.Conclusion:HTO treats patients with medial knee osteoarthritis by correcting mechanical axis of the lower limb.It relieves the clinical symptoms of patients,has a positive short-term effect,and can achieve cartilage regeneration.Combined with arthroscopic treatment,intra-articular lesions such as meniscus injury,loose body and popliteal cyst can be treated in one stage.In addition,the planned axis can be set by directly observing the medial cartilage under arthroscopy,and the mechanical axis correction is more accurate.