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El impacto de la osteotomía de apertura de cuña en la alineación de la columna vertebral
Tetsuro Shimada1, Akira Maeyama1, Tetsuro Ishimatsu1
1Department of Orthopaedic Surgery, Fukuoka University Faculty of Medicine, Fukuoka, JPN.
Cureus
|September 2, 2025
Resumen
La osteotomía de cuña alta (OWHTO) mejora la alineación de la rodilla y tiene un impacto positivo en la alineación lumbar pélvica, reduciendo la inclinación pélvica y la incidencia pélvica-lordosis lumbar. Esta cirugía beneficia tanto a las extremidades inferiores como a la columna vertebral.
Área de la Ciencia:
- La ortopedia
- Biomecánica
- Radiología
Sus antecedentes:
- La contractura de la flexión de la rodilla está relacionada con la postura del tronco hacia adelante y la retroversión pélvica, lo que potencialmente empeora los síntomas de la rodilla.
- Existe una relación bidireccional entre la alineación de la rodilla y la columna vertebral, lo que requiere una investigación sobre las intervenciones quirúrgicas para la osteoartritis de la rodilla.
Objetivo del estudio:
- Evaluar el efecto de la osteotomía tibial de apertura de cuña alta (OWHTO) en la alineación sagital espinopelvica en pacientes con osteoartritis del compartimiento medial de la rodilla.
Principales métodos:
- Análisis retrospectivo de 34 pacientes sometidos a OWHTO para la osteoartritis de rodilla.
- Evaluación radiográfica de la alineación de las extremidades inferiores (eje mecánico, mMPTA, mLDFA, JLCA, PTS) y los parámetros espinopelvicos (inclinación pélvica, pendiente sacra, incidencia pélvica, cifosis torácica, lordosis lumbar, falta de coincidencia PI-LL) preoperatoria y un año después de la operación.
- Los resultados clínicos se evaluaron utilizando el resultado de la lesión de rodilla y la osteoartritis (KOOS, por sus siglas en inglés).
Principales resultados:
- OWHTO redujo significativamente la inclinación pélvica (p = 0,003) y el desajuste entre la incidencia pélvica y la lordosis lumbar (p = 0,044), indicando una mejor alineación sagital espinopelvica.
- No se observó una correlación significativa entre los cambios de alineación espinopelvica postoperatorios y las puntuaciones de KOOS.
Conclusiones:
- OWHTO corrige efectivamente la alineación de las extremidades inferiores y demuestra un impacto positivo en la alineación lumbopelvica, específicamente disminuyendo la inclinación pélvica y el desajuste PI-LL.
- Una mejor distribución de la carga en las extremidades inferiores después de la corrección de la alineación de la rodilla puede contribuir a una mejor alineación lumbopélvica.
Palabras clave:
Alineación lumbar pélvica¿Qué es eso?inclinación pélvicaDesajuste de la pilaAlineación sagital espinopelvicaradiografías de la columna enteraMás Videos Relacionados
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