HTO combined with arthroscopic condylar notch plasty to treat flexion deformity of knee varus osteoarthritis
To explore the clinical results of medial opening high tibial osteotomy (OWHTO) combined with arthroscopic condyle plasty to treat flexion deformity in patients with varus osteoarthritis knees.
From January 2014 to July 2015 , OWHTO combined with arthroscopic condyle plasty were underwent for 11 patients of 11 knees (7 females and 4 males) with a mean age of 52.1 years ( 48 – 58 years) who were diagnosed with varus osteoarthritis and flexion deformity. The degree of varus deformity was assessed via relative position of the tibial plateau and femoral tibial angle on the coronal plane. At the same time arthroscopic condyle plasty assessed via notch width index was performed in order to improve flexion deformity.While the posterior tibial slope was aimed to remain unchanged on the sagittal plane by wedge of bone for all knees intraoperatively. Preoperatively and after 1 year postoperatively, Lyshölm scores,VAS scores and flexion deformity angle were recorded and compared respectively.
All 11 knees were got followed up for more than 1 years, all of whose mechanical axis of lower extremity got through the relative position of tibial plateau (From 17.4± 4.9% to 58.9± 3.1%, P < 0.05) , and femoral tibial angle decreased significantly (From 181.6± 1.2 ° to 170.3 ± 1.3 °, P < 0.05). Flexion deformity angle improve significantly from a mean angle of 11.1± 3.1° to1.4±1.5° (P < 0.05). Femoral notch width Index was increased from 0.221 ± 0.007 to 0.272 ± 0.009 (P < 0.05) while there is no statistical difference for the posterior tibial slope (From 7.7± 2.2 ° to 7.9± 1.9°, P > 0.05). The clinical results improve significantly ( VAS score: from 6.5 ± 1.1 to 2.5 ± 0.8 , P < 0.05; Lyshölm score: from 50.72 ± 6.57 to 75.72 ± 7.41, P<0.05) preoperatively and after 1 year postoperatively.
OWHTO combined with arthroscopic condyle plasty can significantly improve the lower limb line, flexion deformity and clinical outcome in short-term of the knee joint.