記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: To determine whether medialization of the proximal tibia due to a varus deformity is related to lateralization of the tibial tuberosity in varus knee osteoarthritis (OA). METHODS: A total of 120 knees that underwent osteotomies around the knee for varus knee OA were enrolled. Mechanical medial proximal tibial angle (mMPTA) was measured on radiographs. The angle between the mechanical and anatomical axes of the tibia (angle MA) and the distance between the centre of the tibial plateau and the anatomical axis (distance MA) were measured in the coronal plane on computed tomography images. The tibial tuberosity-posterior cruciate ligament (TT-PCL) distance, the distance between the midpoint of the tibial tuberosity and the centre of the tibial plateau (TT-centre distance), and the angle between the line through the midpoint of the tibial tuberosity and the centre of the tibial plateau and the anteroposterior axis (TT-centre angle) were measured in the axial plane. The correlations of these parameters were evaluated. RESULTS: mMPTA correlated negatively with angle MA (r = -0.37, P < 0.01) and distance MA (r = -0.55, P < 0.01). Angle MA and distance MA correlated with TT-PCL distance (r = 0.39, P < 0.01, r = 0.42, P < 0.01), TT-centre distance (r = 0.35, P < 0.01, r = 0.38, P < 0.01) and TT-centre angle (r = 0.36, P < 0.01, r = 0.36, P < 0.01). CONCLUSIONS: Medialization of the proximal tibia due to a varus deformity may induce lateralization of the tibial tuberosity.

DOI： 10.1016/j.knee.2021.03.023

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記述言語：日本語   出版者・発行元：(一社)日本リウマチ学会  

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記述言語：日本語   出版者・発行元：日本リウマチの外科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The purpose of this study was to investigate the healing process of synthetic bone grafts in opening wedge high tibial osteotomy (OWHTO) and to identify the factors that affect bone healing in OWHTO. It was hypothesized that lateral hinge fracture (LHF) is associated with delayed bone healing after OWHTO with synthetic bone grafting. METHODS: The subjects included 350 knees of 283 patients who underwent OWHTO using two wedged blocks of beta-tricalcium phosphate (β-TCP) with 60% porosity. The healing of the osteotomy gap using a radiologic rating system for OWHTO with synthetic bone grafts and the presence of an LHF were assessed up to postoperative 24 months. RESULTS: LHFs were found in 49 knees (14%). The osteotomy gap showed slower progression of radiographic healing with an LHF than without an LHF (P < .05). In the knees with LHFs, initial radiographic change in the osteotomy gap was observed almost at the same time as healing of the LHF. Multivariate logistic regression analysis identified LHF as the factor preventing the progression of bone healing (OR = 46.78, P < .05). CONCLUSIONS: LHF is associated with delayed bone healing after OWHTO with synthetic bone grafting.

DOI： 10.1016/j.knee.2019.10.027

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