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VALGUS HIGH TIBIAL OSTEOTOMY USING TOMOFIX PLATE –MEDIUM-TERM RESULTS IN YOUNG PATIENTS.



Abstract

Purpose of the study: To evaluate the medium-term results of Valgus High tibial osteotomy using tomofix plate in patients with medial compartment arthritis with varus deformity.

Method: A total of 46 patients (50 knees) underwent Valgus High tibial osteotomy. The mean duration of follow-up was 60 months (36 – 72 months). The mean age was 39.5 (range 30–49) and all were male.

The patients were assessed on the basis of pre and post-operative Oxford and Knee society score, range of motion, radiological evidence of healing of the osteotomy site and alignment of the extremity.

Indication for the operation was medial compartment degeneration associated with varus malalignment.

The mean preoperative oxford knee score was 48 (range 38–54) and postoperative score was 22 (range 17–31). The knee score improved from the preoperative mean of 38 (range 30 – 55) to postoperative mean of 82 points (range 45 – 92). The mean preoperative functional score was 35 (range 25 – 55) and mean postoperative functional score was 75 points (range 50 – 95). The preoperative average knee flexion was 110 (Range 90 –130) which at the final follow-up remained unchanged. The mean preoperative Tibio-Femoral angle (mechanical) was 7 degrees varus (range 6–10) and mean postoperative Tibio-Femoral angle was 6.5 deg valgus (range 7–11).

There were no non-unions at the osteotomy site and the medial open-wedge filled-in without any need for bone graft or its substitutes

Conclusion: Our study shows that Valgus High tibial osteotomy for medial compartment arthritis using Tomofix plate gives good medium-term resutls. Longer-term follow-up is needed to establish its effectiveness in deferring joint replacement surgery.

Correspondence should be addressed to: BASK c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.