HIGH TIBIAL OSTEOTOMYWITHOUT FIXATION: TREATMENT OF KNEE OSTEOARTHRITIS

Abstract

Introduction. Considering the high frequency of osteoarthritis of the knee and varus and valgus deformities in this disorder, there are several methods of treatment to reduce patients symptoms. Hight tibial osteotomy and arthroplasty are knowm surgical methods for these patients. Because of socioeconomic problems (about arthroplasty) in our country and unfavorable long term results of it, osteotomy has found a specific position in the treatment of these patients. Osteotomy, itself can be performed in different ways. High tibial osteotomy without internal fixation and secure the osteotomy site on the basis of inherent stability and cast application (external support); reduce the complications and cast of operation and the surgen is able to recorrect the deformity after operation. Also, there is no need for implant removal by the second surgery.
Methods. This quasiexperimental study was performed on 42 patients with osteoarthritis of the knee who refered to Al- zahra hospital orthopedic clinic from October 1997 to October 1999. Their age, physical and radiographic conditions were acceptable for osteotomy (on the basis of texts ). Therefore, the osteotomy was performed and 30 patients were followed for 4 months for probable complications and outcomes. Complications which had been cheked in every visit by physical examination and radiographic imaging, included: loss of reduction, maluniun, nonunion, infection, knee stiffness.
Results. Non of the before mentioned complications were seen. Also no nervous (proneal nerve palsy) and vascular complications were seen in patients in the following period.
Discussion. It can be said that with meticulus operation technique, osteotomy without internal fixation resulted in less complications and costs, ability to recorrect the deformity and no need for implement removal.