Effect Of Zhang’s HTO On The Posterior Inclination Of Tibial Plateau And Patellofemoral Joint After Operation With Different Force Line Positions

Objective:For many patients with early KOA,the lesion is mostly confined to the medial compartment of the knee,and the lesion is relatively mild in the lateral compartment of the knee.Zhang’s high tibial osteotomy(Zhang’s HTO)is an effective treatment method,which can effectively relieve the symptoms of the patients and delay the patients to undergo artificial knee replacement.The main purpose of this operation is to reconstruct the lower extremity line,but the optimal position of the lower extremity line has always been controversial.In this study,the advantages and disadvantages of different force line positions after Zhang’s HTO were evaluated from the Angle of tibial plateau inclination and patella joint,so as to provide reference for clinical practice.Methods:A retrospective analysis was conducted on 45 patients with knee osteoarthritis treated with Zhang’s HTO in the First Central Hospital of Baoding City from November 2018 to September 2019.The medical information of them was collected.The position of the lower limb line passing through the knee joint after surgery was divided into group A: 20 patients passing through the lateral tibial plateau 50%-60%;Group B: 25 patients underwent 60% to 70% lateral tibial plateau.Patients with different surgical positions in the two groups were compared for differences in tibial plateau Angle,Insall-Salvati ratio,patella inclination Angle,lateral patella Angle and patella displacement 6 months after surgery,as well as for differences in preoperative and postoperative values of various indicators between group A and group B.p < 0.05 was considered statistically significant.Results:There were no significant differences in age,gender,body mass index and grade of knee osteoarthritis between 2 groups(p > 0.05).There were no significant differences in tibial plateau posterior inclination,Insall-Salvati ratio,patella inclination,lateral patella Angle and patella lateral displacement between group A and group B 6 months after surgery(p > 0.05).There were no statistically significant differences in tibial plateau Angle,Insall-Salvati ratio,patella inclination Angle,lateral patella Angle and patella displacement between A and B before and after surgery(p > 0.05).Conclusion:Zhang’s high osteotomy does not increase the posterior inclination of the tibial plateau 2.Zhang’s HTO does not change the patella height 3.Postoperative force line located at 50%-70% of the lateral tibial plateau has no effect on the posterior inclination of the tibial plateau and patella joint.Zhang’s HTO improves the function of patients by changing the lower limb line while retaining the original stable structure of the knee joint.It is a simple,easy to master and a knee preservation method that can obtain ideal surgical effect.