Clinical application of Taylor spatial frame in adjustment of lower extremity force line of knee medial compartmental osteoarthritis_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHANG Weiye ¹ ,  WAN Chunyou ² , ZHANG Tao ² , WANG Mingjie ² , LIU Zhao ² , ZHAO Yuanhang ¹

1. Graduate School of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, P.R.China;
2. Department of Limb Orthopaedics, Tianjin Hospital, Tianjin, 300211, P.R.China;

Corresponding author：

WAN Chunyou, Email: wanchunyouxs@163.com

Keywords：

Taylor spatial frame; locking steel plate; knee osteoarthritis; lower extremity force line

DOI：

10.7507/1002-1892.201905106

Video：

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Objective To explore the safety and effectiveness of Taylor spatial frame (TSF) in the treatment of medial compartmental osteoarthritis (MCOA) of the knee and the adjustment of the lower extremity force line at the same time.Methods The clinical data of 30 patients with MCOA who underwent high tibial osteotomy (HTO) between October 2016 and April 2017 were retrospectively analyzed. According to the different fixation methods, they were divided into external fixation group (TSF external fixation, 16 cases) and internal fixation group (locking steel plate internal fixation, 14 cases). There was no significant difference between the two groups in gender, age, side, disease duration, mechanical femur tibia angle (MFTA), and other general data (P>0.05). The operation time and intraoperative blood loss of the two groups were recorded and compared; MFTA was used to evaluate the recovery of the lower extremity force line at last follow-up; Hospital for Special Surgery (HSS) score was used to evaluate the clinical effecacy before operation and at 2 weeks, 1 month, and 3 months after operation.Results The operation time and intraoperative blood loss of external fixation group were significantly less than those of internal fixation group (P<0.05). All patients were followed up 9-16 months, with an average of 12 months. There were 2 cases of delayed healing in the internal fixation group and 1 case of delayed healing in the external fixation group, and all healed after symptomatic treatment. All patients in the two groups had no complication such as needle infection, nonunion at osteotomy, osteomyelitis, and so on. At last follow-up, MFTA standard was used to evaluate the recovery of force line. The results of external fixation group were all excellent, while the results of internal fixation group were excellent in 10 cases and good in 4 cases. The difference between the two groups was significant (Z=–2.258, P=0.024). The HSS scores in the two groups were significantly improved at each time point after operation, and gradually improved with time after operation (P<0.05). The HSS score of the external fixation group was significantly higher than that of the internal fixation group (t=2.425, P=0.022) at 3 months after operation; and there was no significant difference between the two groups at other time points (P>0.05).Conclusion TSF has unique advantages in HTO treatment of MCOA patients and correction of lower extremity force line, such as shorter operation time, less bleeding, firm fixation, and less complications. It can accurately adjust the lower extremity force line after operation and has good effectiveness. It is an effective and safe fixation method.

Citation： ZHANG Weiye, WAN Chunyou, ZHANG Tao, WANG Mingjie, LIU Zhao, ZHAO Yuanhang. Clinical application of Taylor spatial frame in adjustment of lower extremity force line of knee medial compartmental osteoarthritis. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(4): 452-456. doi: 10.7507/1002-1892.201905106 Copy

1.	Ivarsson I, Myrnerts R, Gillquist J. High tibial osteotomy for medial osteoarthritis of the knee. A 5 to 7 and 11 year follow-up. J Bone Joint Surg (Br), 1990, 72(2): 238-244.
2.	Hernigou P, Medevielle D, Debeyre J, et al. Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study. J Bone Joint Surg (Am), 1987, 69(3): 332-354.
3.	Kim HJ, Park J, Shin JY, et al. More accurate correction can be obtained using a three-dimensional printed model in open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc, 2018, 26(11): 3452-3458.
4.	Altman R, Asch E, Bloch D, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum, 1986, 29(8): 1039-1049.
5.	Tseng TH, Tsai YC, Lin KY, et al. The correlation of sagittal osteotomy inclination and the anteroposterior translation in medial open-wedge high tibial osteotomy-one of the causes affecting the patellofemoral joint? Int Orthop, 2019, 43(3): 605-610.
6.	Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis, 1957, 16(4): 494-502.
7.	孔伟, 黄庆红. 双下肢站立位 DR 全长摄影在骨科矫形中的临床价值. 中国医药科学, 2017, 7(3): 137-141.
8.	马继海, 张涛, 海碧霞, 等. 骨外固定动力化治疗开放性胫腓骨骨折. 中国修复重建外科杂志, 2018, 32(2): 174-177.
9.	雍炜, 曹海鲲, 赵远航, 等. Taylor 空间支架在胫腓骨骨折下肢力线调整中的临床应用. 世界最新医学信息文摘, 2018, 18(105): 31-33.
10.	Lawrence RC, Felson DT, Helmick CG, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part Ⅱ. Arthritis Rheum, 2008, 58(1): 26-35.
11.	Lespasio MJ, Piuzzi NS, Husni ME, et al. Knee osteoarthritis: A primer. Perm J, 2017, 21: 16-183.
12.	任燕, 石娅娅, 谭波, 等. 中国人群膝骨关节炎危险因素的 Meta 分析. 现代预防医学, 2015, 42(12): 2282-2284, 2292.
13.	陈蕾, 李江伟, 郑明. 腓骨高位截骨对膝关节应力改变的三维有限元分析. 中国骨与关节损伤杂志, 2018, 33(6): 583-585.
14.	张英泽, 李存祥, 李冀东, 等. 不均匀沉降在膝关节退变及内翻过程中机制的研究. 河北医科大学学报, 2014, 35(2): 218-219.
15.	Bonasia DE, Dettoni F, Sito G, et al. Medial opening wedge high tibial osteotomy for medial compartment overload/arthritis in the varus knee: prognostic factors. Am J Sports Med, 2014, 42(3): 690-698.
16.	Warden SJ, Morris HG, Crossley KM, et al. Delayed-and non-union following opening wedge high tibial osteotomy: surgeons’ results from 182 completed cases. Knee Surg Sports Traumatol Arthrosc, 2005, 13(1): 34-37.
17.	Iorio R, Healy WL. Unicompartmental arthritis of the knee. J Bone Joint Surg (Am), 2003, 85(7): 1351-1364.
18.	Engel GM, Lippert FG 3rd. Valgus tibial osteotomy: avoiding the pitfalls. Clin Orthop Relat Res, 1981, (160): 137-143.
19.	秦泗河, 李刚. Ilizarov 理论与技术的起源、发展与传播史. 中国骨与关节外科, 2010, 3(5): 417-423.
20.	Nishiyama Y, Nakamura M, Henmi C, et al. Development of a three-dimensional bioprinter: construction of cell supporting structures using hydrogel and state-of-the-art inkjet technology. J Biomech Eng, 2009, 131(3): 035001.
21.	葛启航, 万春友, 刘亚北, 等. 胫腓骨开放骨折 Taylor 空间支架外固定术后轴向应力刺激对骨折愈合的影响研究. 中国修复重建外科杂志, 2017, 31(8): 931-935.
22.	刘钊, 万春友, 张涛, 等. 轴向载荷分担比测试辅助 Taylor 空间支架治疗胫腓骨骨折的作用. 中华创伤杂志, 2019, 35(4): 348-353.
23.	Catagni MA, Guerreschi F, Ahmad TS, et al. Treatment of genu varum in medial compartment osteoarthritis of the knee using the Ilizarov method. Orthop Clin North Am, 1994, 25(3): 509-514.
24.	Sen C, Kocaoglu M, Eralp L. The advantages of circular external fixation used in high tibial osteotomy (average 6 years follow-up). Knee Surg Sports Traumatol Arthrosc, 2003, 11(3): 139-144.
25.	Weale AE, Lee AS, MacEachern AG. High tibial osteotomy using a dynamic axial external fixator. Clin Orthop Relat Res, 2001, (382): 154-167.
26.	Henderson DJ, Rushbrook JL, Harwood PJ, et al. What are the biomechanical properties of the Taylor spatial frame^TM? Clin Orthop Relat Res, 2017, 475(5): 1472-1482.
27.	刘少扬, 王明海. 外固定支架钉道感染的预防. 转化医学电子杂志, 2016, 3(1): 61-64.

1. Ivarsson I, Myrnerts R, Gillquist J. High tibial osteotomy for medial osteoarthritis of the knee. A 5 to 7 and 11 year follow-up. J Bone Joint Surg (Br), 1990, 72(2): 238-244.
2. Hernigou P, Medevielle D, Debeyre J, et al. Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study. J Bone Joint Surg (Am), 1987, 69(3): 332-354.
3. Kim HJ, Park J, Shin JY, et al. More accurate correction can be obtained using a three-dimensional printed model in open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc, 2018, 26(11): 3452-3458.
4. Altman R, Asch E, Bloch D, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum, 1986, 29(8): 1039-1049.
5. Tseng TH, Tsai YC, Lin KY, et al. The correlation of sagittal osteotomy inclination and the anteroposterior translation in medial open-wedge high tibial osteotomy-one of the causes affecting the patellofemoral joint? Int Orthop, 2019, 43(3): 605-610.
6. Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis, 1957, 16(4): 494-502.
7. 孔伟, 黄庆红. 双下肢站立位 DR 全长摄影在骨科矫形中的临床价值. 中国医药科学, 2017, 7(3): 137-141.
8. 马继海, 张涛, 海碧霞, 等. 骨外固定动力化治疗开放性胫腓骨骨折. 中国修复重建外科杂志, 2018, 32(2): 174-177.
9. 雍炜, 曹海鲲, 赵远航, 等. Taylor 空间支架在胫腓骨骨折下肢力线调整中的临床应用. 世界最新医学信息文摘, 2018, 18(105): 31-33.
10. Lawrence RC, Felson DT, Helmick CG, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part Ⅱ. Arthritis Rheum, 2008, 58(1): 26-35.
11. Lespasio MJ, Piuzzi NS, Husni ME, et al. Knee osteoarthritis: A primer. Perm J, 2017, 21: 16-183.
12. 任燕, 石娅娅, 谭波, 等. 中国人群膝骨关节炎危险因素的 Meta 分析. 现代预防医学, 2015, 42(12): 2282-2284, 2292.
13. 陈蕾, 李江伟, 郑明. 腓骨高位截骨对膝关节应力改变的三维有限元分析. 中国骨与关节损伤杂志, 2018, 33(6): 583-585.
14. 张英泽, 李存祥, 李冀东, 等. 不均匀沉降在膝关节退变及内翻过程中机制的研究. 河北医科大学学报, 2014, 35(2): 218-219.
15. Bonasia DE, Dettoni F, Sito G, et al. Medial opening wedge high tibial osteotomy for medial compartment overload/arthritis in the varus knee: prognostic factors. Am J Sports Med, 2014, 42(3): 690-698.
16. Warden SJ, Morris HG, Crossley KM, et al. Delayed-and non-union following opening wedge high tibial osteotomy: surgeons’ results from 182 completed cases. Knee Surg Sports Traumatol Arthrosc, 2005, 13(1): 34-37.
17. Iorio R, Healy WL. Unicompartmental arthritis of the knee. J Bone Joint Surg (Am), 2003, 85(7): 1351-1364.
18. Engel GM, Lippert FG 3rd. Valgus tibial osteotomy: avoiding the pitfalls. Clin Orthop Relat Res, 1981, (160): 137-143.
19. 秦泗河, 李刚. Ilizarov 理论与技术的起源、发展与传播史. 中国骨与关节外科, 2010, 3(5): 417-423.
20. Nishiyama Y, Nakamura M, Henmi C, et al. Development of a three-dimensional bioprinter: construction of cell supporting structures using hydrogel and state-of-the-art inkjet technology. J Biomech Eng, 2009, 131(3): 035001.
21. 葛启航, 万春友, 刘亚北, 等. 胫腓骨开放骨折 Taylor 空间支架外固定术后轴向应力刺激对骨折愈合的影响研究. 中国修复重建外科杂志, 2017, 31(8): 931-935.
22. 刘钊, 万春友, 张涛, 等. 轴向载荷分担比测试辅助 Taylor 空间支架治疗胫腓骨骨折的作用. 中华创伤杂志, 2019, 35(4): 348-353.
23. Catagni MA, Guerreschi F, Ahmad TS, et al. Treatment of genu varum in medial compartment osteoarthritis of the knee using the Ilizarov method. Orthop Clin North Am, 1994, 25(3): 509-514.
24. Sen C, Kocaoglu M, Eralp L. The advantages of circular external fixation used in high tibial osteotomy (average 6 years follow-up). Knee Surg Sports Traumatol Arthrosc, 2003, 11(3): 139-144.
25. Weale AE, Lee AS, MacEachern AG. High tibial osteotomy using a dynamic axial external fixator. Clin Orthop Relat Res, 2001, (382): 154-167.
26. Henderson DJ, Rushbrook JL, Harwood PJ, et al. What are the biomechanical properties of the Taylor spatial frame^TM? Clin Orthop Relat Res, 2017, 475(5): 1472-1482.
27. 刘少扬, 王明海. 外固定支架钉道感染的预防. 转化医学电子杂志, 2016, 3(1): 61-64.

Chinese Journal of Reparative and Reconstructive Surgery

Clinical application of Taylor spatial frame in adjustment of lower extremity force line of knee medial compartmental osteoarthritis

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