Abstract
Aim: To introduce and characterize the modified biplanar opening high tibial osteotomy with rigid fixation to treat unicompartmental knee arthritis with varus deformity in active lifestyle patients. Patients and Method: 48 patients (19 females) with monocompartmental gonarthrosis of the knee combined with varus malalignment, 41 with bilateral affection and 7 cases with unilateral gonarthritis (total 89 knees). Mean age: 53 years (range from 42 to 61 years). They were treated and followed from June 2010 to May 2014 (35 months). Biplanar opening high tibial osteotomy technique was used and fixed by low profile locked T-plate (21 cases) and low profile anatomical proximal tibial plate (27cases). Pre-operative mean varus deformity was 16.5° (9° - 19°). We utilized Lysholm score and Knee Society Score for evaluation of preoperative and follow-up data. Results: The average correction angle was 11.50 ± 2.50° (7° - 19°). Preoperative posterior tibial slope was 8.04° ± 1.30° and at last follow-up 9.15° ± 1.60°, respectively (p = 0.437). The joint space distance increased from 4.05 ± 1.30 mm to 4.83 ± 1.33 mm (p < 0.001). The average time to complete bone union was 14.69 ± 1.5 weeks. There were no cases of delayed union or non-union. No major complications like broken plate, nerve injury, or blood vessel injury occurred. No progression of degenerations developed in the three compartments of the knee at final follow-up. The mean score on the Lysholm-Gillquist knee functional scoring scale was 45.5 ± 21.7 preoperatively, and it improved to 77.0 ± 23.9 (p < 0.001). There was no obvious difference in the range of motion before and after operation. The average knee score improved from 51.19 ± 11.82 to 93.49 ± 5.10. Conclusion: Biplanar opening high tibial osteotomy fixed with locking compression plate gives good results for symptomatic unicompartmental gonarthrosis with genu varum. Also this technique can be applied for medial compartment degeneration of the knee without deformity with good functional outcomes.
Highlights
Knee osteoarthritis is viewed as a standout amongst the most widely recognized musculoskeletal disorders in charge of awesome disability especially in old patients and sometimes in youthful dynamic patients
Biplanar opening high tibial osteotomy fixed with locking compression
Modification of the OWHTO technique has been advised later on by many authors and we follow the recommendations of Kim et al, [5] utilizing biplanar open wedge high tibial osteotomy BPOWHTO and the present study was undertaken to evaluate the clinical, functional outcomes and complications occurring after biplanar medial open wedge BPOWHTO in medial osteoarthritis of the knee joint with varus deformity in a prospective case series of 48 patients
Summary
Knee osteoarthritis is viewed as a standout amongst the most widely recognized musculoskeletal disorders in charge of awesome disability especially in old patients and sometimes in youthful dynamic patients It constitutes a noteworthy issue as it influences ordinary every day activities of person. The normal future is getting longer and longer in cutting edge countries so; numerous creators thought about high tibial osteotomy as brief medical procedure until knee arthroplasty This has no negative importance if the brief medical procedure gives help with discomfort of over 10 years, at that point it could give numerous advantages to patients. Modification of the OWHTO technique has been advised later on by many authors and we follow the recommendations of Kim et al, [5] utilizing biplanar open wedge high tibial osteotomy BPOWHTO and the present study was undertaken to evaluate the clinical, functional outcomes and complications occurring after biplanar medial open wedge BPOWHTO in medial osteoarthritis of the knee joint with varus deformity in a prospective case series of 48 patients
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