Hiroshi Nakayama1, Tomoya Iseki2, Ryo Kanto2, Shunichiro Kambara2, Makoto Kanto2, Shinichi Yoshiya2, Steffen Schröter3. 1. Department of Orthopaedic Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 653-8501, Japan. hiroshi0273@mac.com. 2. Department of Orthopaedic Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 653-8501, Japan. 3. Department of Traumatology and Reconstructive Surgery, BG Traumacenter Tübingen, University of Tübingen, Tübingen, Germany.
Abstract
PURPOSE: The purpose of this study was to examine early radiological and clinical outcomes following minimally invasive double level osteotomy (DLO) procedure performed for osteoarthritic knees with severe varus deformity. METHODS: Twenty consecutive patients who underwent DLO for varus osteoarthritic knees were included in the study. All patients could be tracked for a minimum of 1 year. Periodical radiological and clinical evaluations were performed at 6 and 12 months after surgery. In the radiological assessment, the following parameters were measured on full-length weight-bearing radiographs both pre- and postoperatively: mechanical tibiofemoral angle (mTFA), mechanical lateral distal femoral angle (mLDFA), mechanical medial proximal tibial angle (mMPTA), and joint-line convergence angle (JLCA). In addition, subjective clinical results were evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the International Knee Documentation Committee (IKDC) Subjective Score. RESULTS: The mean age of the study population was 62.5 ± 6.8 years (range 45-76 years). In the radiological evaluation, the preoperative mTFA, mLDFA, mMPTA, and JLCA values averaged 13.5° ± 3.1° varus, 91.1° ± 1.4°, 82.3° ± 2.0°, and 5.8° ± 2.3°, respectively. At 6 and 12 months, all of the radiological parameters significantly improved and corrected to the values within normal range. In the clinical assessments at the follow-up evaluations, both the KOOS and IKDC subjective scores significantly improved from the preoperative values. No significant changes were noted between the 6 and 12-month results in the radiological and clinical assessments. CONCLUSIONS: The minimally invasive DLO technique is a valuable surgical technique accomplishing restoration of physiologic knee joint alignment and orientation with significant improvement in patient-registered clinical outcomes in early postoperative evaluation. Although the follow-up period is still short, the excellent clinical and radiological outcomes shown in the present study support the efficacy of this procedure. LEVEL OF EVIDENCE: Retrospective case series, Level IV.
PURPOSE: The purpose of this study was to examine early radiological and clinical outcomes following minimally invasive double level osteotomy (DLO) procedure performed for osteoarthritic knees with severe varus deformity. METHODS: Twenty consecutive patients who underwent DLO for varus osteoarthritic knees were included in the study. All patients could be tracked for a minimum of 1 year. Periodical radiological and clinical evaluations were performed at 6 and 12 months after surgery. In the radiological assessment, the following parameters were measured on full-length weight-bearing radiographs both pre- and postoperatively: mechanical tibiofemoral angle (mTFA), mechanical lateral distal femoral angle (mLDFA), mechanical medial proximal tibial angle (mMPTA), and joint-line convergence angle (JLCA). In addition, subjective clinical results were evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the International Knee Documentation Committee (IKDC) Subjective Score. RESULTS: The mean age of the study population was 62.5 ± 6.8 years (range 45-76 years). In the radiological evaluation, the preoperative mTFA, mLDFA, mMPTA, and JLCA values averaged 13.5° ± 3.1° varus, 91.1° ± 1.4°, 82.3° ± 2.0°, and 5.8° ± 2.3°, respectively. At 6 and 12 months, all of the radiological parameters significantly improved and corrected to the values within normal range. In the clinical assessments at the follow-up evaluations, both the KOOS and IKDC subjective scores significantly improved from the preoperative values. No significant changes were noted between the 6 and 12-month results in the radiological and clinical assessments. CONCLUSIONS: The minimally invasive DLO technique is a valuable surgical technique accomplishing restoration of physiologic knee joint alignment and orientation with significant improvement in patient-registered clinical outcomes in early postoperative evaluation. Although the follow-up period is still short, the excellent clinical and radiological outcomes shown in the present study support the efficacy of this procedure. LEVEL OF EVIDENCE: Retrospective case series, Level IV.
Authors: Philipp Niemeyer; Wolfgang Koestler; Christian Kaehny; Peter C Kreuz; Christopher J Brooks; Peter C Strohm; Peter Helwig; Norbert P Suedkamp Journal: Arthroscopy Date: 2008-04-21 Impact factor: 4.772
Authors: S Schröter; A Ateschrang; W Löwe; H Nakayama; U Stöckle; C Ihle Journal: Knee Surg Sports Traumatol Arthrosc Date: 2015-04-09 Impact factor: 4.342