Literature DB >> 32999578

Functional Outcome of High Tibial Osteotomy in Patients with Medial Compartment Osteoarthritis Using Dynamic Axial Fixator -a prospective study.

Amit Kumar Yadav1, Mangal Parihar1,2, Eknath D Pawar1, Divya Ahuja2, Sandeep Gavhale1, Vikram Khanna2.   

Abstract

INTRODUCTION: Medial Compartment Osteoarthritis of the knee is becoming a widespread problem. The surgical options include high tibial osteotomy, unicompartmental knee replacement, and total knee replacement. Replacement surgeries are not advised in the younger age group, so in these patients, high tibial osteotomy is the only option. In this study, we have assessed the functional and radiological outcomes of high tibial osteotomy done by hemicallostasis method.
METHOD: We report the outcome of 30 patients (30 knees) who underwent hemicallostasis with a dynamic external fixator for medial compartment osteoarthritis of the knee. The radiological assessment was done with the help of Hip Knee Ankle angle. The functional scoring was done via Oxford knee score, IKDC, KOOS, and WOMAC score.
RESULTS: At a mean follow up of 35 months, the preoperatively mean HKA angle was 172 ± 30. The mean HKA angle postoperatively was 184 ± 10. Appropriate correction of the HKA angle was achieved in 24 of 30 patients (80%). Whereas, there was under correction in 3 patients (10%) and overcorrection in 3 (10%) patients. All the functional scores showed significant improvement in the postoperative scores. There was a positive correlation between the HKA angle and oxford, IKDC, KOOS, and WOMAC Score. Complications like superficial pin tract infection were seen in 3 (10%) patients, deep infection in 1 (3%), and early union of osteotomy in 1 (3%) patient leading to revision of the osteotomy. .
CONCLUSION: HTO is effective in improving pain, function, activity of daily living, and quality of life in patients suffering from medial compartment Osteoarthritis of the knee. Hip Knee Ankle Angle is an important parameter to restore for better functional outcomes. The Advantage of using a dynamic axial fixator is the precision in achieving calculated correction without any implant in the bone once the correction is achieved along with good healing rates.
© 2020 Delhi Orthopedic Association. All rights reserved.

Entities:  

Keywords:  Dynamic axial fixator; Hemicallostasis; High tibial osteotomy; Hip –knee –ankle; Medial compartment osteoarthritis

Year:  2020        PMID: 32999578      PMCID: PMC7503148          DOI: 10.1016/j.jcot.2020.07.033

Source DB:  PubMed          Journal:  J Clin Orthop Trauma        ISSN: 0976-5662


  25 in total

1.  Patellar height and the inclination of the tibial plateau after high tibial osteotomy. The open versus the closed-wedge technique.

Authors:  R W Brouwer; S M A Bierma-Zeinstra; A J van Koeveringe; J A N Verhaar
Journal:  J Bone Joint Surg Br       Date:  2005-09

2.  Tibial slope and high tibial osteotomy using the circular external fixator.

Authors:  Taner Gunes; Cengiz Sen; Mehmet Erdem
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2006-08-09       Impact factor: 4.342

3.  Satisfactory functional and radiological outcomes can be expected in young patients under 45 years old after open wedge high tibial osteotomy in a long-term follow-up.

Authors:  Michael E Hantes; Prodromos Natsaridis; Antonios A Koutalos; Yohei Ono; Nikolaos Doxariotis; Konstantinos N Malizos
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2017-11-30       Impact factor: 4.342

4.  High tibial osteotomy: our experience with hemicallotasis method.

Authors:  F Pogliacomi; M Defilippo; A Guardoli; E Scaravella
Journal:  Acta Biomed       Date:  2014-09-24

Review 5.  High tibial osteotomy: indications, techniques, and postoperative management.

Authors:  Chadwick C Prodromos; Annunziato Amendola; Roland P Jakob
Journal:  Instr Course Lect       Date:  2015

6.  Comparative study of high tibial osteotomy using dynamic axial fixator and locked low-profile plate in medial osteoarthritis of knee.

Authors:  Deepak Khurana; Sohan Singh Sankhala; Mudasir Malik; Vishal Shekhawat; Devendra Singh Rathore
Journal:  Eur J Orthop Surg Traumatol       Date:  2014-12-21

7.  Survivorship of medial opening wedge high tibial osteotomy in the elderly: two to ten years of follow up.

Authors:  Pakpoom Ruangsomboon; Keerati Chareancholvanich; Thos Harnroongroj; Chaturong Pornrattanamaneewong
Journal:  Int Orthop       Date:  2017-06-02       Impact factor: 3.075

8.  Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study.

Authors:  P Hernigou; D Medevielle; J Debeyre; D Goutallier
Journal:  J Bone Joint Surg Am       Date:  1987-03       Impact factor: 5.284

9.  Proximal tibial osteotomy. A critical long-term study of eighty-seven cases.

Authors:  M B Coventry; D M Ilstrup; S L Wallrichs
Journal:  J Bone Joint Surg Am       Date:  1993-02       Impact factor: 5.284

Review 10.  Total knee arthroplasty after high tibial osteotomy. A systematic review.

Authors:  Tom M van Raaij; Max Reijman; Andrea D Furlan; Jan A N Verhaar
Journal:  BMC Musculoskelet Disord       Date:  2009-07-20       Impact factor: 2.362

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