Combined medial open-wedge high tibial osteotomy and modified Maquet procedure for medial compartmental osteoarthritis and patellofemoral arthritis of the knee

被引:9
作者
Kim J.-H. [1 ]
Kim J.R. [1 ]
Lee D.H. [1 ]
Bang J.-Y. [1 ]
Hong I.-T. [1 ]
机构
[1] Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Bundang-gu, Sung-nam
关键词
Knee joint; Medial compartmental osteoarthritis; Medial open-wedge high tibial osteotomy; Modified Maquet procedure; Patellofemoral arthritis;
D O I
10.1007/s00590-012-1045-5
中图分类号
学科分类号
摘要
Purpose: Patellofemoral arthritis comes frequently with medial compartmental osteoarthritis. The combination of closed wedge high tibial osteotomy with tibial tuberosity anteriorization osteotomy has been introduced in several reports, but this technique is a technically demanding procedure and the outcomes of this technique show variable results. This article describes a novel osteotomy technique that combines medial open-wedge high tibial osteotomy (HTO) and tibial tuberosity anteriorization osteotomy (TTAO) for medial compartmental osteoarthritis and patellofemoral arthritis of the knee. Methods: Twelve knees in 10 patients who were diagnosed with combined medial compartmental osteoarthritis with patellofemoral compartmental arthritis were treated with the combination of medial open-wedge HTO and TTAO and were followed up for more than 1 year. We evaluated the patients with the Lysholm functional questionnaires, the hospital for special surgery score (HSS), and the international knee documentation committee (IKDC) criteria (mean follow-up, 14.8 months). Results: Union was achieved in all cases within 12 weeks. The mean Lysholm score increased from 42 preoperatively to 82.5 postoperatively (p < 0.001), the HSS increased from 57.5 preoperatively to 83 postoperatively (p < 0.001), and the IKDC score increased from 51 preoperatively to 82 postoperatively (p < 0.001). There were no other complications, such as iatrogenic fractures, nonunion, wound problem, collapse or loss of correction, and so on. Conclusions: The combination of medial open-wedge HTO and modified Maquet procedure (TTAO) is considered to be an effective treatment modality for medial and patellofemoral compartmental osteoarthritis. This technique could, therefore, constantly provide a minimally invasive, precise correction of the deformity and a firm fixation that is enough to allow early rehabilitation. © 2012 Springer-Verlag.
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页码:679 / 683
页数:4
相关论文
共 17 条
[1]  
Amendola A., Bonasia D.E., Results of high tibial osteotomy: Review of the literature, Int Orthop, 34, 2, pp. 155-160, (2010)
[2]  
Coventry M.B., Upper tibial osteotomy for gonarthrosis. The evolution of the operation in the last 18 years and long term results, Orthopedic Clinics of North America, 10, 1, pp. 191-210, (1979)
[3]  
Dowd G.S.E., Somayaji H.S., Uthukuri M., High tibial osteotomy for medial compartment osteoarthritis, Knee, 13, 2, pp. 87-92, (2006)
[4]  
Rudan J.F., Simurda M.A., High tibial osteotomy. A prospective clinical and roentgenographic review, Clinical Orthopaedics and Related Research, 255, pp. 251-256, (1990)
[5]  
Maquet P., Advancement of the tibial tuberosity, Clin Orthop Relat Res, 115, pp. 225-230, (1976)
[6]  
Bourguignon R.L., Combined Coventry-Maquet tibial osteotomy. Preliminary report of two cases, Clinical Orthopaedics and Related Research, 160, pp. 144-148, (1981)
[7]  
Hofmann A.A., Wyatt R.W.B., Jones R.E., Combined Coventry-Maquet procedure for two-compartment degenerative arthritis, Clinical Orthopaedics and Related Research, NO. 190, pp. 186-191, (1984)
[8]  
Nguyen C., Rudan J., Simurda M.A., Cooke T.D., High tibial osteotomy compared with high tibial and Maquet procedures in medial and patellofemoral compartment osteoarthritis, Clin Orthop Relat Res, 245, pp. 179-187, (1989)
[9]  
Putnam M.D., Mears D.C., Fu F.H., Combined Maquet and proximal tibial valgus osteotomy, Clinical Orthopaedics and Related Research, NO. 197, pp. 217-223, (1985)
[10]  
Saito T., Takeuchi R., Ara Y., Yoshida T., Koshino T., High tibial osteotomy with anterior advancement of distal fragment for medial and patellofemoral compartmental osteoarthritis of the knee, Knee, 9, 2, pp. 127-132, (2002)