High tibial osteotomy with a dynamic axial fixator
PRECISION IN ACHIEVING ALIGNMENT
V. Bachhal, MBBS, MSOrtho, DNBOrtho, Registrar in Orthopaedics1; S. S. Sankhala, MBBS, MSOrtho, Professor of Orthopaedics2; N. Jindal, MBBS, Orthopaedic Resident2; and M. S. Dhillon, MBBS, MSOrtho, MNAMS, Professor Head of Orthopaedics1
1 Postgraduate Institute of Medical Education & Research, Sector-12, Chandigarh 160012, India.
2 Sawai Man Singh Medical College & Hospital, Sawai Ramsingh Road, Jaipur 302004, Rajasthan, India.
Journal of Bone and Joint Surgery – British Volume, Vol 93-B, Issue 7, 897-903. doi: 10.1302/0301-620X.93B7.26124
- The authors reported outcome on 32 patients(37knees) who underwent hemicallostasis with a dynamic external fixator for osteoarthritis of the medial compartment of the knee.
- mean age at operationof 54.6 years.
- The aim was to achieve a valgus overcorrectionof 2° to 8° or mechanical axis at 62.5% (± 12.5%).
- At a mean follow-up of 62.8 months the authors found that there was no changein the mean range of movement, and no statistically significantdifference in the Insall-Salvati index or tibial slope (p =0.11 and p = 0.15, respectively).
- The mean hip-knee-ankle angle changed from 190.6 (183° to 197°) to 176.0° (171°to 181°), with a mean final position of the mechanical axisof 58.5% (35.1% to 71.2%).
- The desired alignment was attained in 31 of 37 (84%) knees.
- The authors reported excellent results in 21 patients, 13 good results, two fair and one poor result according to the Oxford knee score with no correlation betweenage and final score.
- This score was at its best at one year with a statistically significant deterioration at two years(p = 0.001) followed by a small but not statistically significant deterioration until the final follow-up (p = 0.17).
- In Ahlback grade 1 osteoarthritis patients the results were excellent or good
- Complications included pin tract infections involving16.4% of all pins used, delayed union in two, knee stiffness in four, fracture of the lateral cortex in one and ring sequestrum in one.
- The authors reported that hemicallostasis provides precision in attaining the desired alignment without interfering with tibial slope or patellar height, and is relatively free of serious complications.
admin says
also read,
http://www.youtube.com/user/mangalparihar#p/a/5203C04B1A741828/0/4fSCH7lQ8Ec
http://www.youtube.com/user/mangalparihar#p/a/5203C04B1A741828/1/J5wJZVxBS8o
http://www.youtube.com/user/mangalparihar#p/a/5203C04B1A741828/2/LXpqbOqp14A