목적: 폐쇄형 및 개방형 경골 근위부 절골술 시행 환자의 술 전, 후 임상적 결과 및 방사선학적 변화를 평가하고자 한다. 대상 및 방법: 폐쇄형 군 75예, 개방형 군 41예였다. 고관절-슬관절-족근관절각(hip-knee-ankle [H-K-A] axis) 및 Ahlback 분류에 따른 관절염 정도를 측정하였다. 슬관절 기능은 Tegner 활동 점수, Lysholm 슬관절 점수, Western Ontario and McMaster University 점수로 평가하였다. 측면 방사선 사진에서 술 전, 후 슬개골의 위치 및 경골 후방 경사각을 측정하였다. 결과: Visual analogue scale 및 운동 범위는 모두에서 호전되었다. H-K-A 축은 내반에서 술 후 외반으로 교정되었고, 점진적으로 내측 관절증이 진행하였다. Body mass index는 관절염 진행과 유의한 연관이 있었다. 슬관절 기능은 전 예에서 호전되었다. 슬개골 높이는 폐쇄형 군은 고위, 개방형 군은 저위 현상이 나타났다. 경골 경사도는 폐쇄형 군은 감소, 개방형 군은 증가하였다. 내반이 재발한 경우는 총 16예였다. 결론: 폐쇄형 및 개방형 경골 근위부 절골술군 모두에서 기능적으로 호전되었으나 명확한 차이는 없었다. 반면, 슬개골의 높이와 경골 경사도는 서로 반대되는 결과를 확인할 수 있었다.
Purpose: The aim of this study is to compare the clinical results and radiologic changes of closing-wedge high tibial osteotomy (CW HTO) and opening-wedge high tibial osteotomy (OW HTO). Materials and Methods: Seventy five knees were treated with a CW HTO and 41 with an OW HTO. For each patient the hip-knee-ankle (H-K-A) axis was evaluated and the degree of the medial compartmental arthrosis was measured by Ahlback-type radiological classification. The function of the knee was evaluated by the Tegner activity score, the Lysholm knee scoring scale and the Western Ontario and McMaster University index. Lateral radiographs were taken to assess the patellar height and the posterior tibial inclination. Results: In both groups significant improvement of the visual analogue scale and range of motion was achieved. The frontal plane H-K-A axis was corrected significantly from varus to the range of physiological valgus and the arthrosis of the medial compartment of the knee progressed gradually. The body mass index was significantly influential to the progression of arthrosis. The functions of the knee were improved significantly in all cases. In the closing-wedge group, the patella height was increased at the postoperative period, while it was decreased in the opening-wedge group. There was a tendency of a decrease of the tibial inclination in the CW HTO group and a statistically significant increase of the tibial inclination in the OW HTO group. Recurrence of varus occurred in sixteen cases. Conclusion: In both groups, improvement of the function of the knee was achieved, but there was no statistical difference. However, the opposite result was found in the patella height and the tibial inclination.