高位脛骨々切り術 (interlocking wedge osteotomy) の術後成績

抄録

Forty patients (51 joints) who underwent high tibial osteotomy were evaluated after a follow-up period ranging from one year and one month to 4 years and 3 months with the average being 2 years and 11 months.
Union was easily achieved and trouble due to antero-medial displacement of the distal fragment was not seen in all patients.
Satisfactory results were obtained in the majority of patients, but unsatisfactory results were obtained in 7 patients (9 joints), who required the use of intraarticular injections or analgesics even one year after operation. Of these 7 patients with poor results, 4 patients (6 cases) resulted from undercorrection due to inaccurate osteotomy, one patient from medial meniscus lesion and another patient from patello-femoral osteoarthritis changes. But there were no known causes in one patient.
Reoperations were performed in 3 patients (total knee replacement, arthroscopic medial meniscectomy, ventralization of tibial tuberosity).
Accurate osteotomy is most important to obtain good result in high tibial osteotomy, but it is not easy to perform accurate osteotomy in the procedure of wedge osteotomy, therefore likewise in this operative procedure, it is necessary to make and use a useful osteotomy guide.