A Study on the Functional Outcome of High Tibal Osteotomy through Medial Opening wedge Technique
Keywords:varus , medial opening wedge osteotomy, high tibial osteotomy, fujisawa point, biplanar osteotomy, Ahlback classification , knee society score, womac score
Introduction: Knee osteoarthritis ranks among the most common disability in adults and often affects medial compartment of the knee leading to varus deformity. High tibial osteotomy is an accepted surgical technique for treatment of medial compartment varus gonarthrosis of the knee especially for younger and active patients..We followed the technique of biplanar medial opening wedge high tibial osteotomy, filled the osteotomy site with beta TCP wedge and fixed with a four holed HTO plate and screws. Purpose of study: To Evaluate the functional and radiological outcome of high tibial osteotomy through medial opening wedge osteotomy in terms of function, pain and patient satisfaction with functional scores and radiological indices and to assess any complications following high tibial osteotomy Background : In this study, we examined the results of medial opening wedge High Tibial Osteotomy by using a HTO plate with beta TCP wedge for patients who suffered from early osteoarthritis of the knee with genu varum deformity. Material and Methods: All patients who underwent a medial opening wedge High Tibial Osteotomy for early osteoarthritis of the knee with genu varum deformity from June 2016 to June 2018 were followed up for a period of minimum of 6 months and maximum of 2 years. Assessment was done for correction of the varus deformity, mechanical axis deviation, hip knee ankle axis, varus regression ,weight bearing line relation to fujisawa point , alterations in tibial slope, insall salvati ratios. Functional outcome of the surgery was assessed with knee society score and womac score. Results : The average knee society score improved from 43.09+/- 6.34 to 62.80+/- 11.66 and 79.15+/- 11.21 respectively on follow ups(p< 0.001) and womac scores improved from 68.11+/-6.52 to 45.61+/-9.80 and 24.69+/-14.24 respectively. Insall salvati ratio decreased from 1.172+/-0.1 to 1.096+/-0.01 post operatively. Tibial slope increased from 11.023+/-0.93 to 11.639+/-0.96 degrees and MPTA values increased from 82.59+/-1.12 to 87.20+/-1.70 degrees. Conclusion: Medial opening wedge High Tibial Osteotomy when performed in early grades of Osteoarthritis has given us good functional outcome. Release of superficial medial collateral ligament and biplanar osteotomy were followed throughout the cases in study which have given good results.
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Copyright (c) 2021 Sailesh Kumar Nadikudi, Deepak Kaki, Jagadesh Guduru, Vidyasagar
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