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KMID : 0361620150500050379
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Journal of the Korean Orthopaedic Association
2015 Volume.50 No. 5 p.379 ~ p.386
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Clinical Results after Medial Opening Wedge High Tibial Osteotomy in Medial Compartment Osteoarthritis of the Knee: TomoFix® versus Aescula® Plates
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이주홍:Lee Ju-Hong
박혁:Park Hyuk/고종현:Ko Jong-Hyun
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Abstract
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Purpose: The purpose of this study was to compare the clinical and radiologic results of medial open wedge high tibial osteotomy (HTO) using either TomoFix® plate (group A) or Aescula® plate (group B) in patients with medial compartment osteoarthritis.
Materials and Methods: Sixty-four consecutive patients who underwent HTO for medial compartmental osteoarthritis from 2008 were included. Mean follow-up duration was 37.1 months. Twenty men and 44 women with a mean age of 50 years (range, 41 to 62 years) were divided into group A (locking plate, n=20) and group B (spacer plate, n=44). Clinical results were evaluated using knee society rating system (KSS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Radiological results were obtained by measuring the mechanical axis, posterior tibial slope, and medial joint space width preoperatively, 3 months postoperatively, and at the final follow-up.
Results: In overall patients, the mechanical axis was corrected from 7.8°±2.4° of varus preoperatively to 1.9°±2.2° of valgus 3 months after HTO. At the final follow-up, the mechanical axis was to 2.1°±3.1° of valgus which showed no statistical difference in group A. However, loss of correction was observed at the final follow-up, at 0.1°±3.1° of valgus angulation in group B. The increase of the posterior tibial slope was significantly greater in group A than group B. The joint space width in both groups was improved at last follow-up. All clinical results showed improvement after HTO, with significantly improved KSS and WOMAC scores (p<0.001).
Conclusion: The overall clinical results after HTO for medial compartment osteoarthritis were satisfactory. A group of spacer plates needed for prolonged protective weight bearing and locking plate was effective in maintenance of correction.
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KEYWORD
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knee, medial compartment osteoarthritis, open wedge high tibial osteotomy, spacer plate, locking plate
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