Knee society score, mechanical tibiofemoral angle and the Fujisawa point: Do these variables determine a successful outcome of a high tibial osteotomy using an ilizarov fixator about the knee for medial compartmental osteoarthritis

Abstract

Introduction: Medial compartment Osteoarthritis is an age related chronic disturbance of weight distribution over the articular surface of the knee joint. The compensatory Varus deformity which develops leads to “bowing” of the legs. Traditionally, treatment involved conservative regimen of analgesics, physiotherapy and lifestyle modifications. Before the advent of Arthroplasty, Osteotomies were the mode the treatment. The treatment modality is divided into two phases. The first phase involves in correcting the mechanical axis deviation, through a high Tibial Osteotomy. The second phase involves stabilizing this accomplishment with an Ilizarov external fixator and achieving the co-linearity of the Mechanical axis of the lower extremity through angular correction using distraction Osteosynthesis. Aim: The aim of present study was to evaluate the results of High Tibial osteotomy using Ilizarov technique in medial compartment osteoarthritis of the knee. Materials and Methods: In this prospective study, thirty cases of medial compartment osteoarthritis of the Knee with genu Varus deformity were treated using monofocal corticotomy and ring fixator. Bone and functional results were evaluated clinically using the Knee Society score (knee score and functional score) and radiologically using the mechanical tibiofemoral angle and the Mechanical axis deviation from the Fujisawa point. Results and Discussion: In the present series of thirty cases, there were 20 females and 2 males with a maximum age of 52 years and minimum of 32 years. There was a predominance of Varus deformity seen on the right knee. The mean follow up was 30 months. The results observed were 60% excellent, 33% fair and 6.7% poor by knee society score. The mean knee society score (Knee score) at 12 months was 71.27 ± 5.32 (p