HIGH TIBIAL OSTEOTOMY USING A LOCKING TITANIUM PLATE WITH OR WITHOUT AUTOGRAFTING

ABSTRACT Objective: To postoperatively evaluate knee scores, radiological assessment results, deficit correction, patellar height change, bone healing time, and weight bearing time in patients undergoing high tibial osteotomy (HTO) with/without autologous iliac bone grafting. Methods: This retrospective examination of treated controls from a randomized controlled study included 63 knees of 58 patients aged 46–59 years who underwent HTO with locking open wedge osteotomy plates. The patients were divided into two groups: Group A, HTO with autologous iliac bone grafts (n = 31); and Group B, HTO without autologous iliac bone grafts (n = 32). Clinical and radiological data were evaluated prospectively at the preoperative consultation and again at 6, 9, and 12 weeks, 6 months, and 1 year after the surgery (and annually thereafter). Results: There were no significant intergroup differences in the radiological assessment, deficit correction, patellar height change, bone-healing time, and weight-bearing time at any time after surgery. The knee scores changed positively in both groups (p < 0.001). Conclusions: There was no difference in the results of patients undergoing HTO with open wedge osteotomy titanium locking plates with or without autografting, and comorbidities resulting from autografts were eliminated with the use of locking plates. Level of evidence III, Retrospective Study.

摘要：
研究目的：旨在评估接受伴/不伴自体髂骨移植（autologous iliac bone grafting）的高位胫骨截骨术（high tibial osteotomy, HTO）患者的术后膝关节评分、影像学评估结果、缺损矫正情况、髌骨高度变化、骨愈合时间及负重时间。
研究方法：本研究对一项随机对照研究的治疗对照组进行回顾性分析，纳入58例患者共63个膝关节，患者年龄介于46~59岁，均接受锁定式开放楔形截骨钢板（locking open wedge osteotomy plates）固定的高位胫骨截骨术。将患者分为两组：A组（n=31）为接受自体髂骨移植的高位胫骨截骨术患者，B组（n=32）为未接受自体髂骨移植的高位胫骨截骨术患者。分别于术前会诊及术后6周、9周、12周、6个月、1年（此后每年）前瞻性收集并评估临床与影像学数据。
研究结果：术后各时间点，两组患者在影像学评估、缺损矫正、髌骨高度变化、骨愈合时间及负重时间方面均无显著组间差异；两组患者的膝关节评分均呈正向改善（p < 0.001）。
研究结论：采用开放楔形钛合金锁定钢板行高位胫骨截骨术的患者，无论是否联合自体骨移植，术后疗效无显著差异；且使用锁定钢板可避免自体移植相关的并发症。本研究证据等级为III级，属于回顾性研究。