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.

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.

Clinical Outcomes of Closing- and Opening-Wedge High Tibial Osteotomy for Treatment of Anteromedial Unicompartmental Knee Osteoarthritis

2018 ◽  
Vol 32 (08) ◽  
pp. 758-763 ◽  
Author(s):  
Jiangfeng Lu ◽  
Shiyu Tang ◽  
Yanru Wang ◽  
Yao Li ◽  
Chang Liu ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Functional Outcomes ◽  
Tibial Slope ◽  
Joint Space ◽  
Posterior Tibial Slope ◽  
Wedge Osteotomy ◽  
Tibial Osteotomy ◽  
Opening Wedge ◽  
Posterior Tibial

AbstractThis article compares the long-term outcomes of closing-wedge osteotomy (CWO) and opening-wedge osteotomy (OWO) in the treatment of unicompartmental medial osteoarthritis with varus deformity. This study included 79 patients who underwent high tibial osteotomy (HTO) between 2002 and 2008. Pre- and postoperative radiography and computed tomography were used to evaluate the posterior tibial slope, the patellar height, the tibiofemoral angle, and the lateral and medial tibiofemoral joint space. Pre- and postoperative severity of arthritis was assessed with the Kellgren–Lawrence grading system. Pre- and postoperative American Knee Society (AKS) score and Lysholm Knee Score (LKS) were determined to evaluate functional outcomes. The duration of follow-up was 86.1 ± 6.2 months. Postoperatively, at the most recent follow-up, there was a slight increase in the size of the medial tibiofemoral joint space after CWO and OWO, which reflected a decrease in stress on the medial compartment and manifested as a significant improvement in the AKS knee and function scores and the LKS. OWO increased the posterior tibial slope as compared with the preoperative value, while CWO reduced the posterior tibial slope. CWO and OWO for HTO resulted in similar functional outcomes. OWO was associated with patella infera and more severe patellofemoral arthritis, while CWO was associated with a greater severity of lateral tibiofemoral arthritis.

scholarly journals Proximal Fibular Osteotomy vs high Tibial Osteotomy in medial compartment Osteoarthritis of knee

2021 ◽  
Vol 12 (6) ◽  
pp. 69-74
Author(s):  
Sujay K Mahadik ◽  
Shriansh Pandey ◽  
Neel S Belsare ◽  
Girish S Shinde ◽  
Shrikant B Deshpande
Keyword(s):  
Functional Outcome ◽  
High Tibial Osteotomy ◽  
Weight Bearing ◽  
Medial Compartment ◽  
Full Weight Bearing ◽  
Tibial Osteotomy ◽  
Complication Rates ◽  
Medial Compartment Osteoarthritis ◽  
Fibular Osteotomy ◽  
Osteoarthritis Of Knee

Background: Osteoarthritis of knee is one of the common conditions seen in older individuals and known to affect quality of life considerably. It makes it difficult for individuals with knee osteoarthritis to climb stairs, walk long distances, and stand for long time and squatting. In intractable cases not responding to conservative management surgical management such as proximal fibular Osteotomy (PFO) or high tibial Osteotomy (HTO) is routinely done. We conducted this comparative study to analyse the functional outcome of patients who had undergone HTO and PFO for medial compartment osteoarthritis of knee joint. Aims and Objectives: 1) To analyse the functional outcome of patients who had undergone HTO and PFO for medial compartment osteoarthritis of knee joint. 2) To compare complication rates in both the groups. Materials and Methods: A total of 60 patients with medial compartment knee osteoarthritis were included in this study on the basis of a predefined inclusion and exclusion criteria. Patients were randomized to 2 groups. Thirty patients undergoing proximal fibular osteotomy (Group A) and 30 patients undergoing high tibial osteotomy (Group B). The patients were followed up for improvements in functional outcome for 12 months. The statistical analysis was done using SSPS 21.0 software and p value less than 0.05 were taken as statistically significant. Results: Mean time for surgery was less for PFO surgery as compared to HTO and the difference was statistically significant. Moreover mean bleeding amount, drainage volume and time required for full weight bearing was low in PFO group as compared to HTO group and the difference was found to be statistically significant (P<0.05). The mean VAS score at the time of presentation in PFO and HTO groups was found to be 4.9 +/- 1.12 and 4.7 +/- 1.02 respectively. A statistically significant reduction in pain was documented at the time of follow up of 4 weeks in both the groups. The functional outcome and complication rates were comparable in both the groups. Conclusion: Proximal fibular osteotomy is a better option as compared to high tibial osteotomy in terms of mean surgery time, mean bleeding amount, drainage volume and time required for full weight bearing. Functional outcome and improvement in VAS were comparable in both the groups.

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