2024 · Clinical Biomechanics
Opening-wedge와 closing-wedge HTO의 보행 변화는 같을까?
두 군의 내반 교정 차이는 없었습니다(P = 0.543). Opening-wedge군은 PTS가 높고 Blackburne–Peel ratio가 낮았습니다(둘 다 P < 0.001).
연구 구조
- 01대상
38명.
- 02방법
후향적 비교: OW 19명, CW 19명. Baseline·1년 보행 분석과 2년 임상·영상 추적을 수행했습니다.
- 03보고 결과
두 군의 내반 교정 차이는 없었습니다(P = 0.543). Opening-wedge군은 PTS가 높고 Blackburne–Peel ratio가 낮았습니다(둘 다 P < 0.001).
논문의 대상·방법·결과를 구분한 설명용 모식도입니다. 원문 figure가 아닙니다.
초록 해설
대상과 방법
주요 결과
진료·수술에서 읽을 지점
해석의 제한
짧게 정리하면
이 연구가 확인한 것은 무엇인가요?
두 군의 내반 교정 차이는 없었습니다(P = 0.543). Opening-wedge군은 PTS가 높고 Blackburne–Peel ratio가 낮았습니다(둘 다 P < 0.001).
개별 환자의 치료 결정에 바로 적용할 수 있나요?
작은 비무작위 코호트 연구입니다. 초록의 결과와 해석에서 시상면 변화의 방향을 설명하는 문구가 서로 일치하지 않아, 군별 수치는 원문 표를 확인해야 합니다. 단기 PFJ 결과에서 차이가 없었다고 해서 장기 결과도 동등하다고 볼 수는 없습니다.
Keywords · 주제어
- Closing wedge osteotomy
- Gait analysis
- High tibial osteotomy
- Open wedge osteotomy
- Osteoarthritis, Knee
- Retrospective Studies
- Treatment Outcome
- Knee Joint
Abstract · 원문 초록
Do Weon Lee, Hyuk-Soo Han, Du Hyun Ro. Comparative analysis of gait: Similar coronal but different sagittal effects between closing-wedge and opening-wedge high tibial osteotomy. Clinical biomechanics (Bristol, Avon). 2024;114:106238. doi:10.1016/j.clinbiomech.2024.106238.
BACKGROUND
High tibial osteotomy is an established surgical option for medial compartment osteoarthritis of the knee with varus alignment. It can be divided into open wedge and closing wedge by operative technique. Although they have fundamental differences, little is known about the biomechanical consequences of the two surgical methods.
METHODS
Thirty-eight patients with medial compartment osteoarthritis who underwent high tibial osteotomy (19 open-wedge and 19 closing-wedge) were retrospectively reviewed. Clinical scores and radiological measurements were assessed until postoperative two years. Gait analysis was performed preoperatively and again at postoperative one year.
FINDINGS
Varus alignment was corrected in both groups without a significant difference between them (p = 0.543). However, posterior tibial slope was higher, and the Blackburne-Peel ratio was lower in the open wedge osteotomy group after surgery (both p < 0.001). Reduction of dynamic knee varus and knee adduction moment were observed in both groups without significant differences. However, after surgery, average knee range of motion (63.3° vs 57.3°, p < 0.001) and the magnitude of knee flexion moment was significantly lower (p = 0.005) in the closing wedge group. There were no significant differences in the Kujala Anterior Knee Pain Scale and the occurrence of patellofemoral arthritis between the groups postoperatively.
INTERPRETATION
After osteotomy, a smaller average knee range of motion in the sagittal plane and a higher knee flexion moment were observed in the open wedge osteotomy group, suggesting quadriceps muscle avoidance. However, no differences in clinical scores or the short-term occurrence of patellofemoral arthritis were noted between the two surgical techniques.
원래 논문
Comparative analysis of gait: Similar coronal but different sagittal effects between closing-wedge and opening-wedge high tibial osteotomy
Do Weon Lee, Hyuk-Soo Han, Du Hyun Ro
Clinical Biomechanics · 2024