• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Survivorship and Complications of the Distal Femoral Osteotomy
【24h】

Survivorship and Complications of the Distal Femoral Osteotomy

机译：股骨远端截骨术的生存和并发症

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Objectives: Distal femoral osteotomy (DFO) is a useful procedure in the young patient with symptomatic unicompartmental osteoarthritis and valgus malalignment to avoid or postpone knee arthroplasty. Distal femoral osteotomy can be technically demanding and various complications are reported in the literature. Our retrospective study aims to evaluate the outcomes and analyze survivorship of the distal femoral osteotomy until eventual conversion to knee arthroplasty. Methods: We performed a retrospective review of 78 open-wedge distal femoral osteotomies done on 74 patients at our institution between 2001 and 2011. The average patient age at surgery is 33 ± 11 years with mean BMI of 28 ± 6. All surgeries were performed by two of the senior authors and 60.3% were done in conjunction with cartilage repair procedures such as autologous chondrocyte implantation and osteochondral graft transfer. Other associated procedures included lateral release, tibial tubercle osteotomy, quadricepsplasty and ACL reconstruction. The average follow-up duration was 43 ± 31 months and the need for further procedures (such as arthroscopic adhesiolysis, hardware removal, revision osteotomy and eventual progression to arthroplasty) was identified with relation to complications. Statistical analyses for survivorship were performed using MedCalc for Windows, version 12.5 (MedCalc Software, Ostend, Belgium). Results: Of the 71 patients who followed -up beyond six months post-operatively, seven eventually converted to total knee arthroplasty (9.9%). The most common complication was hardware pain (20.5%) followed by arthrofibrosis (12.8%). All cases of arthrofibrosis were noted to have had intra-articular surgical manipulation for associated procedures such as cartilage repair. Other less common complications included hardware failure (3.8%), septic arthritis (3.8%) and nonunion (2.6%). Osteotomy hardware removal was performed in fourteen cases (17.9%). Kaplan - Meier survivorship analysis estimates mean survival time of 123 ± 8 months (with 95% confidence interval of 107 - 138) and survival probability at 10 years follow-up is estimated at 78%. Conclusion: Distal femoral osteotomy is an acceptable surgical option for the young patient with severe unicompartmental knee osteoarthritis and malalignment. Its combination with various cartilage repair procedures has been shown to further improve outcomes. Careful selection of each surgical candidate is necessary to ensure maximum benefit. The unloading osteotomy is especially useful in the young, active patient as an adjunct procedure for cartilage repair. However, osteoarthritis continues to progress and multiple arthroscopic or open procedures may be required despite a successful osteotomy. When performed at the optimal time in a carefully selected patient, distal femoral osteotomy can provide adequate joint function for many years until arthroplasty becomes inevitable.
机译：目的：股骨远端截骨术（DFO）在有症状的单室骨关节炎和外翻畸形的年轻患者中是一种有用的方法，可以避免或推迟膝关节置换术。股骨远端截骨术在技术上可能要求很高，文献中报道了各种并发症。我们的回顾性研究旨在评估结果并分析股骨远端截骨术的生存率，直至最终转换为膝关节置换术。方法：我们对2001年至2011年间在我院进行的74例开放性远端股骨远端截骨术进行了回顾性研究。手术的平均患者年龄为33±11岁，平均BMI为28±6。两位资深作者中有60.3％的人是通过软骨修复程序（例如自体软骨细胞植入和骨软骨移植物移植）完成的。其他相关程序包括外侧释放，胫骨结节截骨术，股四头肌成形术和ACL重建。平均随访时间为43±31个月，并确定了与并发症相关的进一步手术（如关节镜粘连溶解，硬件去除，截骨术以及最终发展为关节置换术）的必要性。使用适用于Windows的MedCalc 12.5版（MedCalc软件，比利时奥斯坦德）进行生存率的统计分析。结果：在术后六个月以上随访的71例患者中，有7例最终转变为全膝关节置换术（9.9％）。最常见的并发症是硬性疼痛（20.5％），其次是关节纤维化（12.8％）。注意到所有关节纤维化病例都进行了关节内手术，以进行相关的手术，例如软骨修复。其他较不常见的并发症包括硬件故障（3.8％），化脓性关节炎（3.8％）和骨不连（2.6％）。 14例（17.9％）进行了截骨术。 Kaplan-Meier生存分析估计的平均生存时间为123±8个月（95％的置信区间为107-138），在10年随访中的生存概率估计为78％。结论：股骨远端截骨术是重度单室膝关节骨关节炎和畸形的年轻患者可接受的手术选择。它与各种软骨修复程序的结合已被证明可以进一步改善预后。必须仔细选择每个手术候选人，以确保获得最大利益。卸骨截骨术在年轻，活跃的患者中特别有用，可作为软骨修复的辅助程序。但是，骨关节炎仍在继续发展，尽管截骨手术成功，但仍需要进行多次关节镜或开放手术。在经过精心选择的患者中，在最佳时间进行股骨远端截骨术可以提供很多年的关节功能，直到关节置换术不可避免。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号