Hüseyin S. YERCAN, GÜVENİR OKCU, SEMİH AYDOĞDU, Uğur ÖZİÇ

Diz osteoartritinde lateral kapalı kama yüksek tibial osteotominin klinik sonuçları (Oblik osteotomi ve gergi bandı tespit tekniği)

Amaç: Diz medial kompartman osteoartritinde uyguladığımız oblik ve lateral kapalı kama yüksek tibial osteotominin (OKK-YTO) erken dönem klinik sonuçları değerlendirildi. Çalışma planı: Otuz dokuz hastanın (29 kadın, 10 erkek; ort. yaş 53; dağılım 34-64) dizinde medial kompartman osteoartritinde OKK-YTO ve gergi bandı prensibi ile tespit uygulandı. Ahlback sınıflamasına göre hastaların yedisinde evre II, 27'sinde evre III, beşinde evre IV osteoartrit vardı. Tespit için kama plak ve iki adet kortikal vida kullanıldı. Sonuçlar Amerikan Diz Derneği skoru kullanılarak değerlendirildi. Ortalama izlem süresi 23 ay (dağılım 12-41 ay) idi. Sonuçlar: Ortalama diz skoru 43 puandan (dağılım 18-72) 80 puana (20-90), fonksiyonel skor ise 57 puandan (45-90) 72 puana (35-90) yükseldi (p

Anahtar Kelimeler:

Osteoartrit, diz, Femur, Diz eklemi, Osteotomi, Hareket açıklığı, eklem

Clinical results of lateral closing wedge high tibial osteotomy for osteoarthritis of the knee (Oblique osteotomy with tension band fixation)

Objectives: We evaluated the preliminary results of oblique and lateral closing-wedge high tibial osteotomy for medial compartment osteoarthritis of the knee. Methods: Thirty-nine patients (29 women, 10 men; mean age 53 years; range 34 to 64 years) underwent oblique and lateral closing-wedge high tibial osteotomy followed by tension band plate fixation. According to the Ahlback system, seven patients had grade II, 27 patients had grade HI, and five patients had grade IV osteoarthritis. Fixation was completed with a blade plate and two cortical screws. The results were evaluated using the Knee Society Score at the end of a mean follow-up of 23 months (range 12 to 41 months). Results: The mean pre- and postoperative Knee Society scores were 43 (range 18-72) and 80 (range 20-90), and the mean Knee Function scores were 57 (range 45-90) and 72 (range 35-90), respectively (p<0.05). The mean preoperative deviation from the mechanical axis of the leg was 8.9 degrees varus (range 3 to 15 degrees). A mean correction of 11.6 degrees valgus (range 7 to 18 degrees) was afforded in order to obtain a slight valgus alignment. The mean postoperative femorotibial angle was 171 degrees (range 162-183 degrees). Complications were seen in 11 patients, which included severe overcorrection, fixation failure, transient nerve palsy, or pain over the fibular osteotomy site. Conclusion: Oblique high tibial osteotomy combined with tension band fixation is an effective procedure providing secure and durable fixation to allow early motion. It should be recalled that a high complication rate is likely during the learning curve, which adversely influences the clinical results.

Keywords:

Osteoarthritis, Knee, Femur, Knee Joint, Osteotomy, Range of Motion, Articular,

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