Double-level osteotomy for severe varus osteoarthritic knees can prevent change in leg length and restore physiological joint geometry.
Knee
; 31: 136-143, 2021 Aug.
Article
en En
| MEDLINE
| ID: mdl-34144326
ABSTRACT
BACKGROUND:
It is unclear whether double-level osteotomy (DLO) combining closed-wedge osteotomy in the distal femur and open-wedge osteotomy in the proximal tibia deformity can prevent change in leg length and excessive coronal inclination of the tibial articular surface in surgical correction of the severe varus knee. The purpose of this study was to examine the postoperative change in leg length as well as radiological and clinical outcomes following DLO compared with the results obtained from knees undergoing isolated open-wedge high tibial osteotomy (OW-HTO).METHODS:
In cases of severe varus knee deformity (hip-knee-ankle angle (HKA)â¯>â¯10°) 29 patients undergoing DLO and 35 patients undergoing OW-HTO were included. If the predicted mechanical medial proximal tibial angle (mMPTA) was 95° or greater or the wedge size was 15â¯mm or greater in the surgical simulation, then DLO was considered as the surgical of option. In cases where these criteria were not met, OW-HTO was selected. All patients were followed up for a minimum of 2â¯years.RESULTS:
The changes in the length of the whole leg in the DLO and OW-HTO groups averaged 2.3⯱â¯4.8â¯mm and 9.3⯱â¯7.2â¯mm, respectively (Pâ¯<â¯0.001). mMPTA of more than 95° was found in no knee in the DLO group.CONCLUSIONS:
This study showed that DLO could avoid leg length change and non-physiologic joint lines when performed in patients with varus HKAâ¯>â¯10°, and the predicted mMPTA was 95° or greater or the wedge size was 15â¯mm or greater in the surgical simulation.Palabras clave
Texto completo:
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Bases de datos:
MEDLINE
Asunto principal:
Osteotomía
/
Osteoartritis de la Rodilla
Tipo de estudio:
Prognostic_studies
Límite:
Humans
Idioma:
En
Revista:
Knee
Asunto de la revista:
ORTOPEDIA
Año:
2021
Tipo del documento:
Article