Bilateral HTO in same sitting: Perioperative challenge or feasible option?

Abstract

ObjectiveThe objective of this study was to analyse the feasibility of doing a bilateral high tibial osteotomy in the same sitting for patients with isolated medial compartment osteoarthritis, its effect on Patient Related Outcome Measures at 6 months and 2 years follow up as well as the correction achieved post op. MethodsBilateral simultaneous HTO using Tomofix®(Depuy, Synthes, Warsaw,IN,USA) for medial compartment OA knee was done in 30 patients (60 knees), between April 2010 and August 2014, in the age group of 45–55 years (mean = 48.3 years). The patients were kept non weight bearing for 2 weeks followed by weight bearing as tolerated with crutches from 2 to 4weeks followed by full weight bearing without crutches. Patients were followed up for 2 years. Correction achieved, functional knee score, intra-operative difficulties, post-op complications, rehabilitation difficulties and patient’s overall perception of the procedure were evaluated. ResultsKnee score (Insall modification) improved from mean 41.87 ± 9.7 pre-op to a mean 92.80 ± 2.75 at 2years post op and Pain score (VAS) improved from pre-op mean of 57.90 ± 6.8 to 10.03 ± 6.28 at 2 year post-op, both scores being statistically significant. The femorotibial mechanical angle was corrected from mean 4.1° varus to 1.15° valgus. The osteotomy healed in 5.2 months (4–7 months). There were no complications. ConclusionsBilateral HTO in the same sitting for selected patients is a feasible option without any added complications.