| ObjectiveTo investigate the effect of different osteotomy angles on patella and the relationship between patellar pain and patellar pain after HTO,and to provide theoretical basis for clinical treatment.MethodsFrom January 2015 to March 2019,120 patients with knee osteoarthritis treated by open wedge high tibial osteotomy in the Second Affiliated Hospital of Guangzhou University of traditional Chinese medicine were analyzed retrospectively.The preoperative and postoperative femoral tibial angle(FTA),tibial plateau posterior angle(PTS),all Salvati(is)index and blackbume were measured in the inpatient system Peil(BP)index,patellar camber angle,patellar inclination angle,the influence of different osteotomy angles on patients’femoral tibial angle(FTA),tibial plateau caster angle(PTS),Insall Salvati(is)index,blackbume peel(BP)index,patellar camber angle,patellar inclination angle and their correlation.According to the actual correction angle,they were divided into a(<10°)group,B(10-15 °)group and C(>15°).According to the data of the patients,the patients were followed up by telephone to find out whether there were symptoms of pre patellar pain and to study the correlation between the occurrence of such symptoms and the correction angle.Results120 patients were included,including 35 males and 85 females.According to the actual correction angle,the patients were divided into three groups:a(<10°)group(31 cases),B(10-15°)group(51 cases),C(>15°)group(38 cases).The difference of PTS before and after operation was 3.16±0.82,4.14±0.75 and 4.77±0.65,respectively.There was significant difference between the three groups(P<0.05);the difference of BP index was-0.19±0.09,-0.22±0.09 and-0.31 ± 0.06,respectively.When the correction angle was less than 15 °,the change of BP index of patella height was not significant(P>0.05),but when the correction angle was greater than 15 °,the change of BP index was significant The difference of is index was 0.16±0.06,0.14 ± 0.07 and 0.14 ±0.07 respectively,there was no significant difference between the groups(P>0.05);the difference of patellar camber before and after operation was 1.9±1.44,4.1±0.78 and 4.50 ± 0.68 respectively,there was significant difference between the groups(P>0.05);the difference of patellar inclination was-1.38 ± 0.49,-2.07 ± 0.76 and-2.90±0.67 respectively,there was significant difference between the groups(P>0.05)。The results of Pearson correlation analysis showed that the correlation coefficient r between tibial correction angle and PTS,patellar is index,BP index,patellar camber angle and patellar inclination angle were 0.60,-0.44,0.11,0.64 and 0.66,respectively.Among the patients included,there were 19 patients with prepatellar pain,and their correction angles were more than 10 °and more than 15°.There was a significant difference between the preoperative and postoperative changes of knee joint indexes and those of asymptomatic patients(P<0.05).Although the correlation between the risk of prepatellar pain and the indexes of knee joint was not high,it was significant(P<0.05).ConclusionThe larger the correction angle of open wedge high tibial osteotomy is,the more obvious the change of tibial caster angle,patellar height and patellar trajectory of knee joint is,and there is a moderate correlation with this change;2.When the correction angle is more than 15°,the more obvious the reduction of patellar height is,and the influence of this change should be taken into account in the preoperative planning;3 The greater the angle of correction of open wedge osteotomy is,the more obvious the degree of patellar extraversion and introversion is,which has a great influence on the postoperative activities of patients;4.There is a weak correlation between the risk of anterior patellar pain and the angle of correction,tibial plateau retroversion,patellar height,patellar inclination and patellar extraversion,but the greater the angle of correction is,there is a higher risk of anterior knee pain. |
PDF Full Text Request