Can fixator-assisted plating of focal dome osteotomy accurately correct varus deformity in medial compartment osteoarthritis?

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

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0060 - CORRELATION BETWEEN VARUS DEFORMITY OF THE KNEE AND DYNAMIC BIOMECHANICAL LOADING IN PATIENTS WITH ISOLATED MEDIAL COMPARTMENT OSTEOARTHRITIS LISTED FOR HIGH TIBIAL OSTEOTOMY (HTO)

The Knee ◽

10.1016/j.knee.2017.08.025 ◽

2017 ◽

Vol 24 (6) ◽

pp. VII-VIII

Author(s):

G. Whatling ◽

D.W. Elson ◽

P. Biggs ◽

A. Metcalfe ◽

W. Abdul ◽

...

Keyword(s):

High Tibial Osteotomy ◽

Varus Deformity ◽

Medial Compartment ◽

Tibial Osteotomy ◽

Medial Compartment Osteoarthritis ◽

Biomechanical Loading

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

10.36106/ijsr/8426241 ◽

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.

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Proximal Fibular Osteotomy–A Novel Technique for Decompression of Isolated Medial Compartment Osteoarthritis Knee

Indian Journal of Public Health Research & Development ◽

10.37506/v11/i2/2020/ijphrd/194926 ◽

2020 ◽

Vol 11 (2) ◽

pp. 883

Author(s):

Vishesh Verma ◽

Manjeet Singh ◽

Ashwani Ummat ◽

Praveen Thivari ◽

Harsimarjit Kaur ◽

...

Keyword(s):

Medial Compartment ◽

Medial Compartment Osteoarthritis ◽

Fibular Osteotomy ◽

Novel Technique ◽

Osteoarthritis Knee

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Unicompartmental knee arthroplasty versus High tibial osteotomy in treatment of isolated medial compartment Osteoarthritis of knee: A Systematic Review and MetaAnalysis

QJM ◽

10.1093/qjmed/hcab104.002 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Ibrahim Mostafa El-Ganzoury ◽

Zeiad Mohamed Zakaria ◽

Ahmed Elsayed ◽

Abd Ellah Elwarwary

Keyword(s):

Systematic Review ◽

Total Knee Arthroplasty ◽

High Tibial Osteotomy ◽

Knee Arthroplasty ◽

Unicompartmental Knee Arthroplasty ◽

Meta Analysis ◽

Medial Compartment ◽

Tibial Osteotomy ◽

Medial Compartment Osteoarthritis ◽

Total Knee

Abstract Background Several surgical procedures have been mentioned to treat medial compartment osteoarthritis (OA), as total knee arthroplasty (TKA), unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO). Objectives The aim of the study is a systematic review & meta analysis conducted to compare the outcomes between UKA & HTO in different types of patients diagnosed as an isolated medial compartment OA who treated with UKA or HTO and statistically compare between their results of pain, range of motion, complications, and i ncidence of revision to TKA using studies published between 2009 to 2019 from any country. Patients and Methods The review will be restricted to Randomized controlled trials (RCTs), clinical trials, and comparative studies, either prospective or retrospective, which studied the outcome of HTO versus UKA of isolated medial compartment osteoarthritis patients, articles published in English &published during 2009 to 2019. Results About 150 articles were found using search keywords. By filtration and screening of the title and exclusion of unrelated articles, about 60 articles were found. By applications of all inclusion and exclusion criteria, only 12 articles were fit to undergo this meta-analysis. Conclusion In conclusion, there were no significant differences in the pain score, knee score, complication rate and revision rate to TKA between HTO and UKA, while the HTO group manifested superior ROM compared to the UKA group. So, HTO may be convenient for patients with high activity requirements. Over time, both groups exhibited increased revision rates with the deteriorated clinical outcomes. Therefore when deciding on a therapeutic plan, the ability to revise these failed choices of treatment to a total knee arthroplasty should be a major consideration. This may assist surgeons in their choice. Based on the findings of current meta-analysis, it appears that the two groups have the same efficiency and safety in the treatment of medial knee OA.

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