Clinical and radiological outcomes of high tibial osteotomy with combined fixator-assisted nailing and subtubercle tibial osteotomy

Objective: The aim of this study was to assess the clinical and radiological results of our high tibial osteotomy technique combining f ixator-assisted nailing and subtubercle tibial osteotomy in varus malalignment. Methods: This was a retrospective study of a consecutive series of 32 knees in 32 patients (‘2 follow-up loss’ 12 males and 18 females; mean age at the time of operation: 50.6±7.8 (36–62) years) operated on between 2014 and 2016. Radiographic and clinical measurements were assessed pre- and postoperatively. Kolmogorov-Smirnov, paired t and Wilcoxon rank tests were used in the statistical analyses. Results: The mean follow-up period was 36.1±8.15 (31–53) months, the mean duration of the hospital stay was 3.6±0.1 (2–6) days, and the mean Kellgren-Lawrence score was 2.4±0.6 (2–4). Time to bony union was an average of 16.17 (12–29) weeks. Compared to the preoperative mechanical medial proximal tibial angle, femorotibial angle and mechanical axis deviation measurements, all the postoperative values showed significant changes (p0.05), and the postoperative Caton-Deschamps index did not show a meaningful change (p>0.05). T he postoperative visual analog scale, Knee Society Score, and Modified Hospital for Special Surgery Knee Scoring System measures showed significant improvement compared to the preoperative values (p

___

Aglietti P, Rinonapoli E, Stringa G, Taviani A. Tibial osteotomy for the varus osteoarthritic knee. Clin Orthop Relat Res 1983; 76: 23951. [CrossRef]

Akamatsu Y, Koshino T, Saito T, Wada J. Changes in osteosclerosis of the osteoarthritic knee after high tibial osteotomy. Clin Orthop Relat Res 1997; 334: 207-14. [CrossRef]

Hernigou P, Medevielle D, Debeyre J, Goutallier D. Proximal tibial osteotomy for osteoar-thritis with varus deformity. A ten to thirteen-year follow-up study. J Bone Joint Surg Am 1987; 69: 332-54. [CrossRef]

Robin JG, Neyret P. High tibial osteotomy in knee laxities: Concepts review and results. EFORT Open Rev 2017; 1: 3-11. [CrossRef]

Sabzevari S, Ebrahimpour A, Roudi MK, Kachooei AR. High tibial osteotomy: A systematic review and current concept. Arch Bone Jt Surg 2016; 4: 204-12.

Warner SJ, O’Connor DP, Brinker MR. Subtubercle osteotomy for medial compartment osteoarthritis of the knee using Ilizarov technique: Survival analysis and clinical outcomes. J Bone Joint Surg Am 2018; 100: e1. [CrossRef]

Waugh W. Tibial osteotomy in the management of osteoarthritis of the knee. Clin Orthop Relat Res 1986; 210: 55-61. [CrossRef]

Mina C, Garrett WE Jr, Pietrobon R, Glisson R, Higgins L. High tibial osteotomy for un-loading osteochondral defects in the medial compartment of the knee. Am J Sports Med 2008; 36: 949-55. [CrossRef]

Van Thiel GS, Frank RM, Gupta A, et al. Biomechanical evaluation of a high tibial osteotomy with a meniscal transplant. J Knee Surg 2011; 24: 45-53. [CrossRef]

10. Flecher X, Parratte S, Aubaniac JM, Argenson JN. A 12-28-year followup study of clos-ing wedge high tibial osteotomy. Clin Orthop Relat Res 2006; 452: 91-6. [CrossRef]

11. Hui C, Salmon LJ, Kok A, et al. Long-term survival of high tibial osteotomy for medial compartment osteoar-thritis of the knee. Am J Sports Med 2011; 39: 64-70. [CrossRef]

12. Preston S, Howard J, Naudie D, Somerville L, McAuley J. Total knee arthroplasty after high tibial osteotomy: No differences between medial and lateral osteotomy approaches. Clin Orthop Relat Res 2014; 472: 105-10. [CrossRef]

13. Duivenvoorden T, Brouwer RW, Baan A, et al. Comparison of closing-wedge and opening-wedge high tibial osteotomy for medial compartment osteoarthritis of the knee: A randomized con- trolled trial with a six-year follow-up. J Bone Joint Surg Am 2014; 96: 1425-32. [CrossRef]

14. Adili A, Bhandari M, Giffin R, Whately C, Kwok DC. Valgus high tibial osteotomy. Comparison between an Ilizarov and a Coventry wedge technique for the treatment of medial compartment osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc 2002; 10: 169-76. [CrossRef]

15. Woodacre T, Ricketts M, Evans JT, et al. Compli-cations associated with opening wedge high tibial osteotomy-a review of the literature and of 15 years of experience. Knee 2016; 23: 276-82. [CrossRef]

16. Noyes FR, Goebel SX, West J. Opening wedge tibial osteotomy: The 3-triangle method to correct axial alignment and tibial slope. Am J Sports Med 2016; 33: 378-87. [CrossRef]

17. Bin SI, Kim HJ, Ahn HS, Rim DS, Lee DH. Changes in patellar height after opening wedge and closing wedge high tibial osteotomy: A meta-analysis. Arthroscopy 2016; 32: 2393-400. [CrossRef]

18. Gunes T, Sen C, Erdem M. Tibial slope and high tibial osteotomy using the circular exter-nal fixator. Knee Surg Sports Traumatol Arthrosc 2007; 15: 192-8. [CrossRef]

19. Ducat A, Sariali E, Lebel B, et al. Posterior tibial slope changes after opening- and closing-wedge high tibial osteotomy: A comparative prospective multicenter study. Orthop Traumatol Surg Res 2012; 98: 68-74.

20. Kocaoglu M, Bilen FE. Fixator-assisted nailing for correction of long bone deformities. Oper Tech Orthop 2011; 21: 163-73. [CrossRef]

21. Paley D, Herzenberg J, Bor N. Fixator-assisted nailing of femoral and tibial deformities. Tech Orthop 1997; 12: 260-75. [CrossRef]

22. Thévenin-Lemoine C, Ferrand M, Courvoisier A, Damsin JP, Ducou le Pointe H, Vialle R. Is the Caton-Deschamps index a valuable ratio to investigate patellar height in children? J Bone Joint Surg Am 2011; 93: e35. [CrossRef]

23. Feldman DS, Henderson ER, Levine HB, et al. Interobserver and intraobserver reliability in lower-limb deformity correction measurements. J Pediatr Orthop 2007; 27: 204-8. [CrossRef]

24. Durandet A, Ricci PL, Saveh AH, et al. Radiographic analysis of lower limb axial alignments. Proceedings of the World Congress on Engineering 2013 July 3-5; London, UK.

25. Nowicki PD, Vanderhave KL, Farley FA, Kuhns LR, Dahl W, Caird MS. Reliability of digital radiographs for pediatric lower extremity alignment. J Pediatr Orthop 2012; 32: 631-5. [CrossRef]

26. Kellgren JH, Lawrence JS. Radiological assessment of osteoarthrosis. Ann Rheum Dis 1957; 16: 494-502. [CrossRef]

27. Kuwano T, Urabe K, Miura H, et al. Importance of the lateral anatomic tibial slope as a guide to the tibial cut in total knee arthroplasty in Japanese patients. J Orthop Sci 2005; 10: 42-7. [CrossRef]

28. Bourne RB, Finlay JB, Papadopoulos P, Rorabeck CH, Andreae P. In vitro strain distri-bution in the proximal tibia. Effect of varus-valgus loading in the normal and osteoarthritic knee. Clin Orthop Relat Res 1984; 188: 285-92. [CrossRef]

29. Robinson PM, Papanna MC, Somanchi BV, Khan SA. High tibial osteotomy in medial compartment osteoarthritis and varus deformity using the Taylor Spatial Frame: Early results. Strategies Trauma Limb Reconstr 2011; 6: 137-45. [CrossRef]

30. Loia MC, Vanni S, Rosso F, et al. High tibial osteotomy in varus knees: Indications and limits. Joints 2016; 4: 98-110. [CrossRef]

31. Rossi R, Bonsai DE, Amendola A. The role of high tibial osteotomy in the varus knee. J Am Acad Ortho Surg 2011; 19: 590-9. [CrossRef]

32. Wright JM, Crockett HC, Slawski DP, Madsen MW, Windsor RE. High tibial osteotomy. J Am Acad Ortho Surg 2005; 13: 279-89. [CrossRef]

33. Brosset T, Pasquier G, Migaud H, Gougeon F. Opening wedge high tibial osteotomy per-formed without filling the defect but with locking plate fixation (TomoFix™) and early weight-bearing: Prospective evaluation of bone union, precision and maintenance of correction in 51 cases. Orthop Traumatol Surg Res 2011; 97: 705-11. [CrossRef]

34. Tuncay I, Bilsel K, Elmadag M, Erkocak OF, Asci M, Sen C. Evaluation of mobile bearing unicompart-mental knee arthroplasty, opening wedge, and dome-type high tibial osteotomies for knee arthritis. Acta Orthop Traumatol Turc 2015; 49: 280-7.

35. Portner O. High tibial valgus osteotomy: closing, opening or combined? Patellar height as a determining factor. Clin Ortho Relat Res 2014; 472: 3422-40. [CrossRef]

36. Nelissen EM, van Langelaan EJ, Nelissen RG. Stability of medial opening wedge high tibial osteotomy: A failure analysis. Int Orthop 2010; 34: 217-23. [CrossRef]

37. Tunggal JA, Higgins GA, Waddell JP. Complications of closing wedge high tibial osteot-omy. Int Orthop 2010; 34: 255-61. [CrossRef]

38. Sen C, Kocaoglu M, Eralp L. The advantages of circular external fixation used in high tibial osteotomy (average 6 years follow-up). Knee Surg Sports Traumatol Arthrosc 2003; 11: 139-44. [CrossRef]
Acta Orthopaedica et Traumatologica Turcica-Cover
  • ISSN: 1017-995X
  • Başlangıç: 2015
  • Yayıncı: Türk Ortopedi ve Travmatoloji Derneği
Sayıdaki Diğer Makaleler

Matrix induced autologous chondrocyte implantation in the knee: Comparison between osteochondritis dissecans and osteonecrosis and effect of chondrocyte thickness on prognosis

Murat AYDIN, Mehmet YORUBULUT, Kerem BAŞARIR, Murat ARIKAN, Mehmet Serdar BİNNET

T he congress was a great success: Yes, but what about research?

Merter YALÇINKAYA, Erdem BAGATUR

Diagnostic importance of clinicopathologic features and p16, CD34, MDM2 expression in differential diagnosis of adipocytic tumors

EREN ALTUN, Seher YÜKSEL, Gülşah KAYGUSUZ, Hüseyin Yusuf YILDIZ

Center-edge angle values in healthy children between 5 and 14 years old in Turkey

Ali İhsan TUĞRUL, Yılmaz GÜNEY, Bahattin Kerem AYDIN, İbrahim AKEL, Fatih DURGUT, Hakan ŞENARAN

Clinical and radiological outcomes of high tibial osteotomy with combined fixator-assisted nailing and subtubercle tibial osteotomy

LEVENT BAYAM, Mehmet ERDEM, Deniz GÜLABİ, Ahmet Can ERDEM, Ahmet Çağrı UYAR, Alauddin KOCHAİ

Minimally invasive medial plate osteosynthesis in tibial pilon fractures: Longterm functional and radiological outcomes

Alican Barış, Esra ÇİRCİ, Ziya DEMİRCİ, Yusuf ÖZTÜRKMEN

Cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures: A randomized controlled trial with two years follow-up

Igor MOVRİN

Clinicopathological value of ErbB2 gene and protein expression in osteochondroma

Zhen HUANG, Sheng-Lin WANG, Qing-Shan HUANG, Xiao-Dong Lİ, Hui CHEN, Jian-Hua LİN

Biomechanical comparison of Bunnell, modified Kessler, and Tsuge tendon repair techniques using two suture types

Nuh DÜNDAR, Bülent GÜNERİ, Murat ÜZEL, ADEM DOĞANER

Efficacy and safety of tranexamic acid for reducing blood loss in elderly patients with intertrochanteric fracture treated with intramedullary fixation surgery: A meta-analysis of randomized controlled trials

Xiangping LUO, Hangqing HUANG, Xiong TANG