scholarly journals MID TERM OUTCOME OF OPEN WEDGE HIGH TIBIAL OSTEOTOMY AT ORTHOPAEDICS DEPARTMENT OF DMCH, LAHERIASARAI, BIHAR

2021 ◽  
pp. 1-2
Author(s):  
Kunal Shankar ◽  
Vikash M. Harinandan ◽  
Laljee Chaudhary ◽  
Debarshi Jana
Keyword(s):  
Survival Rate ◽  
Varus Deformity ◽  
Flexion Contracture ◽  
Medial Compartment ◽  
Wedge Osteotomy ◽  
Bony Union ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Medial Compartment Osteoarthritis ◽  
Active Patients

Introduction: High tibial osteotomy (HTO) is a common surgical technique for isolated medial compartment osteoarthritis of tibio-femoral component of knee, indicated in young and active patients with varus deformity. It can be performed by lateral closed wedge osteotomy, medial open wedge osteotomy and dome osteotomy. Purpose of this study was to evaluate the (1) Incidence and severity of complications after medial open wedge osteotomy, (2) functional outcome, (3) survival rate of HTO, (4) incidence of revision to TKR. Materials And Methods: We have evaluated 32 knees in 27 patients operated during last 3 years (August 2016 to July 2019) who have undergone Medial open wedge HTO for Unicompartmental (medial) OA of knee. The indications for surgery were medial compartment osteoarthritis with varus deformity of knee, young and active patients with age < 55yrs, progressive symptoms unresponsive to conservative treatment for at least 6 months, >90˚ of flexion, flexion contracture <10˚, intact cruciates and collaterals. Post-operatively, patients were followed up every month till bony union, thereafter every 3 months for 1yr post-surgery, at final follow-up and were evaluated for the complications and the functional outcome using HSS knee score. Results: The mean duration of bony union was 12 weeks (10-16). All the pre-operative range of movements was retained post-operatively. HSS knee score has increased significantly following medial open wedge HTO. 5 year-survival rate was 100% and 10 year-survival rate was 87.5%. Four patients were revised to total knee replacement (12.5%). In our study, overall complication rate was 10.93%. Conclusion: Success of arthroplasty in recent decades has degraded HTO lately, but HTO is still a viable option for young and active patients with medial compartment osteoarthritis of knee with varus deformity, with flexion >90˚, with flexion contracture < 10˚. It is less expensive and no changes in lifestyle are required which is very useful in Indian perspective. It retains all the pre-operative movements and helps in delaying total knee arthroplasty.

The Outcome of Tricalcium Phosphate Wedges Used in Opening High Tibial Osteotomy

2016 ◽  
Vol 695 ◽  
pp. 139-143
Author(s):  
Ioan Cristescu ◽  
Cristi Angheluta ◽  
Florin Safta ◽  
Daniel Vilcioiu ◽  
Alsed Gjoni ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Tricalcium Phosphate ◽  
Bone Substitutes ◽  
Medial Compartment ◽  
Wedge Osteotomy ◽  
Osteoarthritis Of The Knee ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Medial Compartment Osteoarthritis ◽  
Wedge High Tibial Osteotomy

In the case of patients suffering from medial compartment osteoarthritis of the knee, a high tibial osteotomy is the preferred treatment for preserving the knee articulation and correcting the knee biomechanical axis. Nowadays, the open wedge high tibial osteotomy is the preferred surgical technique for treating patient with varus knee angulation. The procedure consists in creating a medial gap in the proximal tibial metaphysis that is filled with autologus bone graft or bone substitutes. Synthetic bone substitutes made by bioceramics like hydroxyapatite or tricalcium phosphate are becoming more popular. Tricalcium phosphate (TCP) used as a bone substitute has shown to have osteoconductive properties and it is resorbable. We describe our experience in Orthopaedics III Department of the Clinical Emergency Hospital Bucharest, where we treated a total of 26 patients suffering from medial compartment osteoarthritis of the knee with high tibial open wedge osteotomy, between 2011 and 2015. TCP wedge implants were successfully used as bone substitutes for the tibial medial osteotomy in conjunction with a proximal tibia plate and screws. Open wedge high tibia osteotomy used for correcting the biomechanical axis of the lower limb is a safe surgical procedure that preserves the anatomical knee joint.

scholarly journals Evaluation of lateral closed wedge high tibial osteotomy for medial compartment osteoarthritis

2015 ◽  
Vol 14 (4) ◽  
pp. 389-392
Author(s):  
VedPal Yadav ◽  
Anil Juyal ◽  
Sansar Sharma
Keyword(s):  
Range Of Motion ◽  
High Tibial Osteotomy ◽  
Tertiary Care ◽  
Medical Science ◽  
Young Patients ◽  
Varus Deformity ◽  
Medial Compartment ◽  
Tibial Osteotomy ◽  
Medial Compartment Osteoarthritis ◽  
Good Range

Introduction: Osteoarthritis of the knee is a common orthopaedic condition. Medial compartment osteoarthritis results from undue stress on the medial compartment of the knee joint following varus deformity. High tibial osteotomy (HTO) has been a long-standing treatment for osteoarthritis of the medial compartment of the knee. Although knee replacement has gained wide popularity for its treatment, still HTO is a good and cost effective procedure for young patients having good range of motion and uni-compartmental involvement. Objective: To evaluate the results of HTO in medial compartment osteoarthritis. Methods and Material: This study was conducted in a tertiary care teaching hospital of North India over a period of 3 years. The patients with disabling knee pain due to medial compartment osteoarthrosis with genu varus deformity refractory to conservative treatment were treated by High Tibial Osteotomy. Results: Overall 40 patients with medial compartmental osteoarthritis were treated with HTO. Patients were evaluated for the severity of pain as per Visual Analogue Score (VAS). There was satisfactory pain reduction (up to 80%) in most of the patients. Conclusions: HTO is a good procedure for young patients with good range of motion and changes confined to one compartment only.Bangladesh Journal of Medical Science Vol.14(4) 2015 p.389-392

scholarly journals Impact of medial open-wedge high tibial osteotomy for medial compartment osteoarthritis of the knee

2020 ◽  
Vol 11 (12) ◽  
pp. 606-614
Author(s):  
Sunil Sheshrao Nikose ◽  
Devashree Nikose ◽  
Aditya L Kekatpure ◽  
Shashank Jain ◽  
Kiran Saoji ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Medial Compartment ◽  
Osteoarthritis Of The Knee ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Medial Compartment Osteoarthritis ◽  
Wedge High Tibial Osteotomy

scholarly journals Comparison of Sagittal and Frontal Plane Alignment after Open- and Closed-Wedge Osteotomy: A Matched-Pair Analysis

2008 ◽  
Vol 36 (5) ◽  
pp. 1085-1093 ◽  
Author(s):  
TK Schaefer ◽  
M Majewski ◽  
MT Hirschmann ◽  
NF Friederich
Keyword(s):  
Frontal Plane ◽  
Varus Deformity ◽  
Tibial Slope ◽  
Matched Pair ◽  
Wedge Osteotomy ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Matched Pair Analysis ◽  
Closed Wedge ◽  
Open Wedge Hto

High tibial osteotomy (HTO) is a procedure for treating medial compartment osteoarthritis (OA) of the varus deformed knee. Frontal and sagittal alignment after closed- and open-wedge HTO were compared radiologically in a matched-pair study. The mean intra-operative frontal plane correction (FT axis) was +7.5° for closed-wedge HTO and +8° for open-wedge HTO; it increased by +0.5° in closed-wedge HTO and decreased by −0.5° in open-wedge HTO at last follow-up. Post-operatively, tibial slope had decreased by −0.5° in closed-wedge HTO and increased significantly by +3° in open-wedge HTO. Both techniques effectively and safely corrected varus deformity. A high degree of stability of the frontal plane correction was noted, however a significant change in the tibial slope after open-wedge HTO was observed post-operatively. As no loss of correction was shown, it may be related to the surgical technique rather than to the implant used.

EARLY OUTCOMES OF HIGH TIBIAL OSTEOTOMY USING DYNAMIC AXIAL EXTERNAL FIXATOR IN MEDIAL COMPARTMENT OSTEOARTHRITIS OF KNEE.

2021 ◽  
pp. 4-8
Author(s):  
T.K.Jeejesh kumar ◽  
Albert Issac ◽  
Puneeth K Pai ◽  
Priyavrata Rajasubramanya
Keyword(s):  
High Tibial Osteotomy ◽  
External Fixator ◽  
Functional Outcomes ◽  
Medial Compartment ◽  
Wedge Osteotomy ◽  
Tibial Osteotomy ◽  
Management Options ◽  
Opening Wedge ◽  
Medial Compartment Osteoarthritis ◽  
Osteoarthritis Of Knee

Structured abstract:Medial compartment osteoarthritis of knee in young adults has a variety of management options. Realignment surgeries by high tibial osteotomy unload the medial joint and are gaining popularity with increasing focus on knee preservation surgeries. Medial opening wedge osteotomy is one such time tested technique with the fixation being done using internal or external fixators. Here we present the early outcomes of infra-tubercle medial opening wedge osteotomy using a dynamic axial external fixator. Methodology: A single group cohort study was conducted to assess the functional outcomes of high tibial osteotomy with a uni-axial dynamic external fixator for medial compartmental osteoarthritis in younger patient. Results:Function was assessed using knee scores at 6 months and 12 months follow-up which was 85.5 and 83.1 respectively. On bivariate analysis of pre and post-operative Knee-scores, significant improvement was noted with average being 44.2 ± 4.01 which was statistically significant p value-<0.00001. Excellent results were obtained in 15 cases (75%) and good results in 5 cases (25%). Three patients developed pin track infections and were treated with antibiotics and pin tract care. Conclusion: High tibial osteotomy using dynamic external fixator is a simple and effective option for management of medial compartment osteoarthritis in young patients with good short-term functional outcomes and low risk of infection.

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