The Medium And Long-term Effect Analysis Of Knee Joint Osteoarthritis By High Tibial Osteotomy

Objective:To analyze the medium and long-term results of high tibial osteotomy(HTO)for the treatment of knee joint osteoarthritis(OA).Methods:From January 2001 to December 2005,45 patients(63 knees)with medial compartment OA were treated with HTO,including 10 males(15 knees)and 35 females(48 knees),ranging in age from 45 to 64 years old with an average of(55.76±5.54)years old.Preoperative normal anterroposterior and lateral X-ray films of weight-bearing knee were conducted,with accurate measurement of the the femoral tibial angle(FTA),and the mass of lateral tibial osteotomy was determined according to preoperative FTA.Routine HTO was performed after epidural anesthesia.Most patients were treat with middle part fibulae osteotomy,and some patients were treat with the released of proximal tibiofibular joints.The functional exercise-no weight-bearing ambulation and weight-bearing began on the second day operation 2 weeks after operation and 8 to 10 weeks after operation respectively.All the cases should be examined with X-ray postoperatively on second days,8 to 10 weeks,6 months,1 year after operation and once a year.The VAS,HSS,KSS were used to evaluate knee pain,deformity,function,and range of motion respectively preoperatively,3 to 5 years postoperatively,10 to 14 years postoperatively in all the patients.The HSS and KSS scores of 50 KOA patients treated with UKA were analyzed statistically.Results:Forty-three patients(61 knees)were followed up for more than 10 years.All the incisions were healed at the frist stage.The bone healing was achieved 8 to 10 weeks after operation.The knee joint was evaluated according to the HSS standard 10 to 14 years after operation,and the average score was 76.24±5.27.Twenty-seven patients got an excellent result,25 good,7 fair and 2 poor.The VAS,HSS and KSS scores of postoperative 3 to 5 years and 10 to 14 yeras were better than those of beforeoperation.There were no obvious differences of scores between postoperative 3 to 5 years and postoperative 10 to 14 years.Conclusion:The long-term curative affective effect of high tibial osteotomy in the treatment of knee OA(medial compartment arthritis)is satisfied,if the indications for surgical treatment is appropriate,and postoperative active exercise are performed.There was no significant difference between UKA group and control arm in terms of HSS and KSS scores.