The rationale for proximal tibial osteotomy is to correct the abnormal loading stresses on the knee that are caused by an abnormal tibiofemoral axis in the coronal plane. But postoperative rehabilitation has often been long and difficult.
The mothods of fixation are cast, staple, plate and external fixation etc., among them conventional Coventry staple had been used most widely. But conventional Coventry staple has some disadvantages such as inadequate fixation, need of cast
immobilization for 6 weeks, and readmission for rehabilitation.
The purpose of this paper is to demonstrate the superior performance of rehabilitation of the newly designed Miniplate staple over the conventional Coventry staple. We have analyzed the changes of rehabilitation of 15 patients, 21 cases which had
used
newly designed Miniplate staple in proximal tibial osteotmy. Preoperative diagnosis was osteoarthritis in 15 cases(71.4%), physiologic genu varum in 6 cases(28.k6%).
1. the range of motion was average 129.4 degrees preoperatively, 135.3 degrees postoperatively.
2. HSS knee score was average 81.9 points preopersatively, 89.4 points postoperatively.
3. The tibiofemoral angle was average varus 3.8 degrees preoperativgely, valgu s 8.4 degrees postoperatively.
4. The ROM exercise started at 8 days, standing at 15 days, crutch ambulation at 22 days and ambulation without crutch at 53dyas postoperatively.
5. The radiological bone union observed at average 5 weeks 4 days postoperatively. In conclusion, early early range of motion exercise could be started without aplication of long leg cast. The newly designed Miniplate staple can provide better
postoperative fixation in high tibial osteotomy.
|