Combined Intra-Articular and Varus Opening Wedge Osteotomy for Lateral Depression and Valgus Malunion of the Proximal Part of the Tibia
| Autor: | Maarten V. Rademakers, Mark Altena, Gino M. M. J. Kerkhoffs, René K Marti |
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| Přispěvatelé: | Other Research, Orthopedic Surgery and Sports Medicine |
| Rok vydání: | 2008 |
| Předmět: |
Adult
Male musculoskeletal diseases medicine.medical_specialty Adolescent Knee Joint medicine.medical_treatment Osteoarthritis Osteotomy Risk Factors medicine Humans Orthopedics and Sports Medicine Malunion Tibia Range of Motion Articular Depression (differential diagnoses) Aged biology business.industry General Medicine Middle Aged Plastic Surgery Procedures musculoskeletal system biology.organism_classification medicine.disease Surgery Radiography Joint Deformities Acquired Valgus Treatment Outcome Orthopedic surgery Female Range of motion business Follow-Up Studies |
| Zdroj: | Journal of bone and joint surgery. American volume, 90A(6), 1252-1257. Journal of Bone and Joint Surgery Inc. |
| ISSN: | 0021-9355 |
| Popis: | BACKGROUND: Reconstructive surgical measures for treatment of posttraumatic deformities of the lateral tibial plateau are seldom reported on in the literature. We report the long-term follow-up results of a consecutive series of reconstructive osteotomies performed to treat depression and valgus malunions of the proximal part of the tibia. METHODS: From 1977 through 1998, a combination of an intra-articular elevation and a lateral opening wedge varus osteotomy of the proximal part of the tibia was performed in twenty-three consecutive patients. The patients were assessed clinically and radiographically at a minimum of five years postoperatively. RESULTS: A correction of the intra-articular depression and the valgus malalignment was achieved and the anatomic lower-extremity axis was restored in all patients. The clinical results were evaluated at a mean of thirteen years (range, two to twenty-six years) after the reconstructive osteotomy. Two patients had an early failure and were considered to have had a poor result. Two other patients had severe progression of osteoarthritis after the osteotomy, four had slight progression, and fifteen had no progression. There were no nonunions. There were two superficial wound infections, which were treated successfully without surgical intervention. According to the scale of Lysholm and Gillquist, the subjective result was excellent for seventeen patients (74%), good for three, fair for one, and poor for two. CONCLUSIONS: A knee-joint-preserving osteotomy can provide satisfactory results in active patients with painful posttraumatic lateral depression and valgus malunion of the proximal part of the tibia. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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