Abstract: Objective To investigate the effect of high tibia osteotomy(HTO) on knee osteoarthritis and medial knee function. Methods A total of 126 patients with osteoarthritis of the medial compartment of knee joint who were surgically treated in Zhengzhou University Hospital were selected as the research subjects. Among them, 61 patients were treated with HTO technology(HTO group) and 65 patients were treated with unicompartmental knee arthroplasty(control group). The surgical trauma and postoperative rehabilitation indicators, knee function, knee imaging features, and surgical complications in the two groups were statistically analyzed. Results The operation time, intraoperative blood loss, and incision length of the HTO group were lower than those of the control group, and the difference was statistically significant(P<0.05). Compared with that before operation in this group, there were significantly higher(P<0.05). Six months after operation, the posterior inclination angle of tibial plateau and lateral patellar angle in HTO group and control group were significantly higher than those before operation(P<0.05). The femoral-tibial angle, patellar fit angle and patellar inclination angle of the patients in the group were significantly lower than those before operation(P<0.05). Conclusion The effect of HTO in the treatment of osteoarthritis of the medial compartment of knee joint is not much different from that of single knee replacement surgery. On the basis of ensuring the surgical effect, it has the advantages of short operation time, less bleeding and less trauma.

Key words: high tibia osteotomy, knee osteoarthritis, knee arthroplasty

摘要： 目的 探讨胫骨高位截骨术（HTO）治疗膝关节内侧间室骨关节炎的效果及对膝关节功能的影响。方法 选取于郑州大学医院实施手术治疗的126例膝关节内侧间室骨关节炎患者作为研究对象,其中61例患者采用HTO技术治疗（HTO组）,另外65例患者采用膝关节单髁置换术（对照组）治疗。统计学分析2组的手术创伤及术后康复指标、手术前后膝关节功能、膝关节影像学指标及手术并发症。结果 HTO组患者的手术时间、术中出血量、切口长度均低于对照组,差异具有统计学意义（P<0.05）;在术后3个月、6个月,HTO组和对照组的Lysholm评分较本组术前均显著升高（P<0.05）;在术后6个月,HTO组和对照组的胫骨平台后倾角、外侧髌骨角较术前均显著升高（P<0.05）,2组患者的股胫角、髌骨适合角、髌骨倾斜角较术前均显著降低（P<0.05）。结论 HTO治疗膝关节内侧间室骨关节炎的效果与膝关节单髁置换术差异不大,在保证手术效果的基础上具有手术时间短、出血少、创伤小的优势,2种手术方法的远期疗效差异尚需要进一步延长观察时间后分析。

关键词: 胫骨高位截骨术, 膝关节骨关节炎, 膝关节单髁置换术