Outcome of High Tibial Osteotomy in Patients with Osteoarthritis Knee
Journal Title: Journal of Pakistan Orthopaedic Association - Year 2018, Vol 30, Issue 04
Abstract
Objective: To determine the radiological, functional and anatomical outcome in patients with osteoarthritic knee undergoing high tibial osteotomy. Methods: This descriptive study was conducted in the Orthopedic Departments of District Head Quarter Hospital Faisalabad affiliated with Punjab Medical University Faisalabad from Jan 2016 to March 2018.A total of 40 patients of both genders, between 40-65 years of age having advanced degenerative disease of knee limited to medial compartment of joint. Medial open wedge osteotomy was done and outcome was evaluated after 5 years of surgery in terms of radiological knee mechanics, functional outcome scores and arthroscopic evidence of cartilage regeneration in the medial compartment. A signed written consent was taken from every patient. Results: There was a female predominance(1:4 male female ratio) .The mean age of the patients was 53.2±6.9 years. The values of the radiographic parameters signi?cantly changed from pre-operative condition after high tibial osteotomy; MTFA (-8.1±1.2o vs. 2.5±1.2o; p-value<0.0001), TPI (5.3±1.1o vs. 3.4±1.1o; p-value<0.0001), G-KJLO (0.3±0.1o vs. 4.6±1.5o; p-value<0.0001) and G-AJLO (8.3±3.2o vs. 2.3±1.7o; p-value<0.0001). There was significant improvement in patient’s functional status; KOOS-ADL score (45.5±7.8 vs. 73.7±8.6; p-value<0.0001), IKDC score (42.4±6.9 vs. 68.5±12.7; p-value<0.0001), IKS score (149.4±11.9 vs. 179.4±10.2; p-value<0.0001), KSS (54.2±5.6 vs. 69.7±12.7; p-value<0.0001) and HSS (50.8±3.3 vs. 64.8±10.7; p-value<0.0001). 42.5% patients showed excellent regeneration of femoral and 30.0% patients showed excellent regeneration of tibial cartilage in the medial compartment. Conclusion: By significantly alternating the knee biomechanics, high tibial osteotomy was found to unload the medial compartment leading to regeneration of the articular cartilage and dramatic improvement in the symptoms and quality of life of these patients. It is therefore recommended in the management of patients with arthritic changes limited to medial compartment only
Authors and Affiliations
M. Khurram Habib,Zeeshan Ali Khan
Keywords
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