Résumé
Resumo Perante a realidade atual de exploração excessiva dos recursos naturais, a bioética promove um importante debate interdisciplinar abrangendo ramos éticos e científicos. Por muitos anos, um processo de industrialização expressivo aumentou a produção de bens de consumo e gerou uma mentalidade consumista. A valorização da lucratividade e do consumismo evidenciaram os impactos do conheci mento perigoso, a exemplo do uso indiscriminado de agrotóxicos e de testes de engenharia genética. Nesse contexto, a população teve acesso a uma quantidade extraordinária de informações, embora não soubesse como utilizá-las de maneira adequada, fato que salienta a importância da bioética para mediar conflitos, promovendo uma discussão entre especialistas e a população. Por fim, ressalta-se a necessidade de conscientizar as pessoas quanto aos impactos ambientais de suas atividades, objetivando mudar atitudes em relação ao ambiente e possibilitar um convívio mais harmônico entre os seres humanos e as diferentes espécies animais e vegetais.
Abstract Given the current reality of excessive exploitation of natural resources, bioethics promotes an important interdisciplinary debate encompassing ethical and scientific branches. For many years, a significant industrialization process has increased the production of consumer goods and generated a consumerist mentality. The valuation of profitability and consumerism has highlighted the impacts of dangerous knowledge, such as the indiscriminate use of pesticides and genetic engineering tests. In this context, the population had access to an extraordinary amount of information, despite not knowing how to properly use it, a fact that highlights the importance of bioethics to mediate conflicts, promoting a discussion between experts and the population. Finally, the need to make people aware of the environmental impacts of their activities is stressed, aiming to change attitudes towards the environment and enabling a more harmonious coexistence between human beings and the different animal and plant species.
Resumen En el contexto actual de excesiva explotación de los recursos naturales, la bioética impulsa un importante debate interdisciplinar que abarca ramas éticas y científicas. Durante mucho tiempo, el proceso de industrialización incrementó la producción de bienes de consumo y generó una actitud consumista. La valorización de la rentabilidad y el consumismo puso en evidencia los impactos de conocimientos peligrosos, como el uso indiscriminado de plaguicidas y las pruebas de ingeniería genética. En este contexto, la población tuvo acceso a mucha información, aunque no sabía utilizarla adecuadamente, lo que destaca la importancia de la bioética para mediar en los conflictos, impulsando un debate entre los expertos y la población. Además, hay la necesidad de concienciar a las personas sobre los impactos ambientales de sus actividades para cambiar las actitudes hacia el medio ambiente y permitir una convivencia más armoniosa entre los seres humanos y las diferentes especies animales y vegetales.
Résumé
PURPOSE: The purpose of this study was to evaluate the mid to long-term clinicoradiological results of open wedge high tibial osteotomy performed as the primary treatment for medial unicompartmental osteoarthritis of the knee and to analyze the factors that affect the survival rate. MATERIALS AND METHODS: The study cohort consisted of 124 patients who underwent open wedge high tibial osteotomy for medial unicompartmental osteoarthritis of the knee and had a minimum follow-up period of five years. Hospital for special surgery (HSS) and the Western Ontario and MacMaster (WOMAC) scores, tibiofemoral angle, mechanical axis of lower limb, medial proximal tibia angle, and tibia posterior slope angle were used to evaluate the clinical and radiographic outcomes over the mean follow-up period of 85 months. The risk factors that affected the survival rate were calculated by multivariate regression analysis. RESULTS: Mean HSS scores and WOMAC scores showed significant improvements at the final follow-up. The tibiofemoral angle was improved to 8.4 degrees of valgus after surgery. A total of 12 patients (9.7%) failed to survive until the final follow-up resulting in 8 year survivorship of 90.3%. Risk factors significantly affecting the survival rate afteropen wedge high tibial osteotomy included a high body mass index (BMI), severe varus deformity, severe osteoarthritis (Kellgren-Lawrence Grade III or IV) preoperatively and overcorrection angles in operation. CONCLUSION: Open wedge high tibial osteotomy showed good clinical and radiological outcomes in the current study. Analysis of the risk factors influencing survivorship after open wedge high tibial osteotomy suggests that the surgical procedure be avoided or modified with patients who have a high BMI, severe varus deformity, or severe osteoarthritis symptoms preoperatively.