ABSTRACT
Background: Varus alignment associated with medial compartment degeneration is the most common presentation of knee osteoarthritis and often presents in young active adults where arthroplasty might be unsuitable. Purpose: To compare the accuracy of the angle stable medial high tibia plate and self-adjusting HTO (high tibial osteotomy) fixator in achieving correction of varus deformity of the knee by medial opening wedge HTO and to evaluate functionality between the groups. Study Design: Prospective randomized control study. Methods: Forty patients each underwent medial opening wedge high tibial osteotomy with acute correction and stabilization using the angle stable plate (ASP group) or with the hemicallotasis technique using the self-adjusting HTO external fixator (HCO group). Anatomical and functional outcomes were compared to the pre-operative values at the 6th and 12th month. Results: The FTA (femoro-tibial axis), mechanical axis, and functional scores improved significantly in both groups. There was also a significant change in the patellar height and tibial slope. Except for a better KOOS (Knee Injury and Osteoarthritis Outcome Score) in the angle stable plate group at the 6-month follow-up, there were no significant differences between the groups. Conclusion: Both methods of performing a medially based proximal tibial osteotomy gave equivalent outcomes at the 1-year follow-up.
ABSTRACT
Introduction: Tibial tuberosity avulsion fractures in adolescents are one of the rare physeal injuries. Sudden powerful contraction of quadriceps muscle leads to avulsion fractures and varying degrees of disruption of extensor mechanism. Case Report: A 16-year-old boy sustained tibial tuberosity avulsion fracture while playing football and presented with sudden onset of pain, massive swelling, and loss of active extension of the left knee along with inability to bear weight on the left leg. Due to imminent risk of development of compartment, patient was taken for surgical correction immediately. Open reduction and internal fixation were done using 02 × 4 mm partially threaded cannulated cancellous screws. Patient was immobilized with above knee cast and kept non-weight bearing for 6 weeks. Later, gradual weight bearing ambulation was allowed and ROM and strengthening of knee was carried out. Patient had regained complete ROM of knee and returned to sporting activities by end of 6 months. Conclusion: Tibial tuberosity avulsion fractures are a rare occurrence and even rarer is them getting complicated by compartment syndrome. A high index of suspicion for development of compartment syndrome in an avulsion fracture of tibial tuberosity and a timely management can avert such potential complications and enables to achieve an optimal results.