Results of corrective tibial osteotomy in osteoarthrosis of the medial part of the knee joint

Authors

  • Igor Zazirniy

DOI:

https://doi.org/10.15674/0030-59872009410-15

Keywords:

proximal tibial osteotomy, open angle, medial osteoarthritis

Abstract

Purpose: The present work was to study the results of corrective osteotomy in osteoarthrosis of the medial compartment of the knee joint. Methods: Forty-eight patients were treated; they underwent high valgus corrective osteotomies for medial arthrosis of the knee joint. In order to assess the treatment results, Lysholm knee, visual analogous and IKDC-2000 scales were used before the operation, as well as 6, 12 and 24 months after it. Results: Excellent and good results were achieved in 67.5 % of cases. Eighty-six per cent of patients developed better clinical results 24 months later versus their preoperative state. After the above period, 67.5 % of patients returned to the level of their initial sports activity. In one case, an articular fracture in the lateral part of the tibial plateau was observed as a surgical complication. One patient revealed an early infection of the area of osteotomy (on day 14 after the operation). Conclusions: Proximal tibial osteotomy along the medial surface with an open edge and use of a plate of Puddu type proved to be an effective procedure. The obtained results show that the best result of the oeration in the majority of patients was achieved within 12-24 months. This fact is a ground for removing implants not earlier than month 24 after the operation.

References

  1. Зазірний І.М. Хірургічне лікування остеоартрозу колінного суглоба / І.М. Зазірний, М.К. Терновий. — Київ: Навчальна книга, 2005. — 192 с.
  2. High tibial valgus osteotomy for medial gonarthrosis: a 10 — to 21-year study / P. Aglietti, R. Buzzi, L.M. Vena et al. // J. Knee Surg. — 2003. — Vol. 161. — P. 21–26.
  3. Effect of high tibial flexion osteotomy on cartilage pressure and joint kinematics: a biomechanical study in human cadaveric knees / J.D. Agneskirchner, C. Hurschler, C. Stukenborg-Colsman et al. // Arch. Orthop. Trauma Surg. — 2004. — Vol. 1249. — P. 575–584.
  4. Asik M. High tibial osteotomy with Pudu plate for the treatment of varus gonarthrosis / M. Asik, C. Sen, B. Kilic // Knee Surg. Sports traumatol. Arthrosc. — 2006. — Vol. 1410. — P. 948–954.
  5. Benedetto K.P. Proximale tibiaosteotomy mit der spaserplatte / K.P. Benedetto // Arthroscopie. — 2007. — Vol. 20. — P. 301–307.
  6. Blackburne J.S. A new method of measuring patellar height / J.S. Blackburne, T.E. Peel // J. Bone Joint Surg. Br. — 1977. — Vol. 592. — P. 241–242.
  7. Britberg M. Evaluation of cartilage injures and repair / M. Britberg, C.S. Winalski // J. Bone Joint Surg. — 2003. — Vol. 85. — P. 58–69 (Suppl. 2).
  8. Brouwer R.W. Osteotomy for medial compartment arthrosis of the knee using a closing wedge or an opening wedge controlled by a Pudu plate. A one-year randomized, controlled study / R.W. Brouwer, S.M. Bierma-Zeinstra, T.M. van Raaij // J. Bone Joint Surg. Br. — 2006. — Vol. 8811. — P. 1454–1459.
  9. Coventry M.B. Osteotomy about the knee for degenerative and rheumatoid arthritis / M.B. Coventry // J. Bone Join Surg. Am. — 1973. — Vol. 551. — P. 23–48.
  10. Fujisawa Y. The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints / Y. Fujisawa, K. Masuhara, S. Shiomi // Orthop. Clin. North Am. — 1979. — Vol. 103. — P. 585–608.
  11. Griffin T. Unicompartment knee arthroplasty for the treatment of unicompartmental osteoarthritis: A systematic study / T. Griffin, N. Rowden, D. Morgan // ANZ J. Surg. — 2007. — Vol. 774. — P. 214–221.
  12. Hassenpflug J. Long — term results of tibial head osteotomy [in German] / J. Hassenpflug, A. von Haugwitz, H.J. Hahne // Z. Orthop. Ihre Grenzgeb. — 1998. — Vol. 1362. — P. 154–161.
  13. Normal axial alignment of the lower extremity and load-bearing distribution at the knee / R.W. Hsu, S. Himeno, M.V. Coventry, E.Y. Chao // Clin. Orthop. Relat. Res. — 1990. — Vol. 255. — P. 215–227.
  14. Morbidity from iliac crest bone harvesting / W.W. Kalk, G.M. Raghoebar, J. Jansma, G. Boering // J. Oral Maxillofac. Surg. — 1996. — Vol. 5412. — P. 1424–1429.
  15. Lisholm J. Evaluation of knee ligament surgery results with special emphasis on use of scoring scale / J. Lisholm, J. Gillquist // Am. J. Sports Med. — 1982. — Vol. 103. — P. 150–154.
  16. Lobenhoffer P. Impruvements in surgical technique of valgus high tibial osteotomy / P. Lobenhoffer, J.D. Agneskirchener // Knee Surg. Sports. Traumatol. Arthrosc. — 2003. — Vol. 113. — Р. 132–138.
  17. Lobenhoffer P. Open valgus ali- gnment osteotomy of the proximal tibia with fixation by medial plate fixator / P. Lobenhoffer, J. Agneskirchner, W. Zoch // Orthopade. — 2004. — Vol. 332. — P. 153–160.
  18. Accuracy of frontal and sagital plane correction in open-wedge high tibial osteotomy / C.B. Marti, E. Gautier, S.W. Wachtl, R.P. Jacob // Arthroscopy. — 2004. — Vol. 204. — P. 366–372.
  19. Moore T.M. Roentgenographic measurement of tibial plateu depression due to fracture / T.M. Moore, J.P. Harvey Jr // J. Bone joint Surg. Am. — 1974. — Vol. 561. — P. 155–160.
  20. Moreland J.R. Radiografic analysis of the axial alignment of the lower extremity / J.R. Moreland, L.W. Basset, G.J. Hanker // J. Bone Joint Surg. Am. — 1987. — Vol. 695. — P. 745–749.
  21. Moss A.L. The morbidity of harvesting bone fron the iliac crest / A.L. Moss // Cleft Palate Craniofac. J. — 2000. — Vol. 373. — P. 326.
  22. The install award. Survivonship of the high tibial valgus osteotomy. A 10- to 22 — year follow-up study / D. Naudie, R.B. Bourne, C.H. Rorabeck, T.J. Bourne // Clin. Orthop. Relat. Res. — 1999. — Vol. 367. — P. 18–27.
  23. Noyes F.R. A rationale for assessing sports activity levels and limitations in knee disorders / F.R. Noyes, S.D. Barber, L.A. Mooar // Clin. Orthop. Relat. Res. — 1989. — Vol. 246. — P. 238–249.
  24. Rupp S. Unstellungosteotomie: [Kohn D., Wirth C.J. Zichner L.]. — 2003. — Vol. 85. — P. 58–69 (Suppl 2).
  25. Spahn G. Complication in high tibial (medial opening wedge) osteotomy / G. Spahn // Arch. orthop. Trauma Surg. — 2004. — Vol. 12410. — P. 649–653.
  26. Sprenger T.R. Tibial osteotomy for the treatment of varus gonarthrosis. Survival and failure analysis to 21 years / T.R. Sprenger, J.F. Doerzbacher // J. Bone Joint Surg. Am. — 2003. — Vol. 85. — P. 469–474.
  27. Staubli A.E. Radiologische heilungsvorgange nach offenender kniegelenksnaher tibiaosteotomie / Lobenhoffer A.G. [ed. Kniegelenksnahe osteotomien]. — New York: Georg Thieme Verlag, 2006. — P. 67–78.
  28. Tomofix: A new lcp-concept for open wedge osteotomy for medial proximal tibia-early results in 92 cases / A.E. Staubli, C. De Simoni, R. Babst, P. Lobenhoffer // Injury. — 2003. — Vol. 34. — P. 55–62 (suppl 2B).
  29. Patella height after high tibial osteotomy with internal fixation and early motion / G.H. Westrich, L.E. Peters, S.B. Haas // Clin.Orthop. Relat Res. — 1998. — P. 354. — P. 169–174.

Downloads

How to Cite

Zazirniy, I. (2009). Results of corrective tibial osteotomy in osteoarthrosis of the medial part of the knee joint. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (4), 10–15. https://doi.org/10.15674/0030-59872009410-15

Issue

No. 4 (2009)

Section

ORIGINAL ARTICLES

License

Copyright (c) 2014 Igor Zazirniy

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

The authors retain the right of authorship of their manuscript and pass the journal the right of the first publication of this article, which automatically become available from the date of publication under the terms of Creative Commons Attribution License, which allows others to freely distribute the published manuscript with mandatory linking to authors of the original research and the first publication of this one in this journal.

Authors have the right to enter into a separate supplemental agreement on the additional non-exclusive distribution of manuscript in the form in which it was published by the journal (i.e. to put work in electronic storage of an institution or publish as a part of the book) while maintaining the reference to the first publication of the manuscript in this journal.

The editorial policy of the journal allows authors and encourages manuscript accommodation online (i.e. in storage of an institution or on the personal websites) as before submission of the manuscript to the editorial office, and during its editorial processing because it contributes to productive scientific discussion and positively affects the efficiency and dynamics of the published manuscript citation (see The Effect of Open Access).