| ObjectiveThis study aimed to evaluate the outcomes after OWHTO for the treatment of medial knee osteoarthritis and provide theoretical support for the clinic treatment.MethodsFrom January 2016 to June 2017,19 OWHTOs were performed in 18 patients,who hospitalized in The third orthopaedic of The first affiliated hospital of guangzhou university of Chinese medicine.All paitiets were treated with Tomofix plate fixation and implanted with allograft bone block.Preoperative and postoperative KSS score,OKS score,Femoral Tibial Angle(FTA),tibial posterior slope angle,Insall-Salvati(IS)index,Blackbume peel index,patellar suitable angle,patellar lateral angle,patellar tilt angle were recored in all cases,retrospectively.We study the result and the relationship of FTA and tibial posterior slope angle.Result18 OWHTOs(19 knees)were identified,which have 12 women and 6 men with a average age of 63.39 years(53-76 years)in this retrospectively study.The average follow-up period is 3.89 months(3-12months).The average KSS clinical score were 75.79-11.50 points postoperatively,compared to 46.26±20.81 points preoperatively.The average KSS functional score were 75.26±12.96 postoperatively,compared to 51.11 + 16.13 points preoperatively.The average OKS score were 21.58±7.54 postoperatively,compared to 41.63±7.74 points preoperatively.The average FTA were 169.16 ° + 3.85 ° postoperatively,compared to 181.22°±4.32°preoperatively and the satisfaction rate was89.47%.The average tibial posterior slope angle were 13.81 ° ± 5.75 °postoperatively,compared to 9.44°±4.46°preoperatively(P=0.0003),The average IS index were 1.08±0.14 postoperatively,compared to 1.07±0.16preoperatively(P=0.7172).The average Blackbume peel index were 0.67±0.17 postoperatively,compared to 0.88 ± 0.24 preoperatively(P=0.0023).The average patellar suitable angle were-5.83 ° ± 9.27 ° postoperatively,compared to-2.88°±8.14°preoperatively(P=0.1786).The average patellar lateral angle were 13.17°±4.84°postoperatively,compared to 10.23°±4.93 ° preoperatively(P=0.0002).The average patellar tilt angle were15.63°±4.97°postoperatively,compared to 17.46°±5.22°preoperatively(P=0.0178).Our study suggested there is no obvious correlation between FTA and tibial posterior slope angle(r = 0.13,P= 0.58).ConclusionThe clinical outcomes of OWHTO is satisfied for the treatment of medial knee osteoarthritis.The operation procedure could raise the joint surface,causing low patellar,For some patients with low patellar preoperation,OWHTO should be carefully considered in case of lower patellar and limitations of joint function.There was no significant difference of the insall-salvati index after operation,indicating that the operation had no significant effect on the length of the patellar ligament lately.The OWTHO could change the inclination of the patella and the lateral patellar angle,however,it had no obvious effect on patellar suitable Angle.The OWHTO could improve the fitness of patellofemoral joint and the funciton of patella.The OWHTO may increase the tibial posterior slope angle,however,there was no realationship between changes of tibial posterior slope angle and the corrective angle.The changes of tibial posterior slope angle may result from surgical procedure.As a result,the surgeons should adjust the tibial posterior slope angle according to patients for better outcomes. |
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