Functional and radiological outcome of high tibial osteotomy in osteoarthritis patients with varus knee

Abstract

Introduction: Osteoarthritis can affect any synovial joint in the body, however it occurs most often in weight-bearing joints, with the knee being one of the most commonly affected. Progressive loss of hyaline articular cartilage is often considered the hallmark of the disease. There are concomitant changes in the bone underneath the cartilage including sclerosis (remodelling and thickening) of the subchondral bone, and formation of osteophytes. Within the tibiofemoral joint; articular cartilage degradation is most prevalent in the medial compartment. Many techniques have been developed (i.e. closing wedge, opening wedge, dome and “en chevron” osteotomies), but opening (medial) and closing (lateral) wedge osteotomies are the most commonly used. The goal of the treatment is to relieve medial compartment knee pain and slow down the arthritic progression. Materials and methods: This prospective non-randomized comparative study was carried out over a period of 12 months in a sample size of 30 adult patients of age more than 40 years with medial compartment osteoarthritis at Rajendra Institute of Medical Sciences [RIMS], Ranchi. Patients were followed up for 6 months and functional and radiological outcome were assessed based on knee society score 1(KSS1), knee society score functional (KSS2) and LYSHOLM scoring system. Result: The average age of patients in this study was 54.8 years, with a female predominance (61.2%). KSS1 results were excellent in 80%, good in 14.4% and poor in 5.6% of patients. In terms of knee society score functional (KSS2) results were excellent (86.7%), good (13.3%). LYSHOLM Score results included excellent (20.2%), Good (46.6%), fair (26.6%), poor (6.6%). Conclusion: The present study shows that HTO is a good option in isolated medial compartment OA of knee. It works by unloading the medial compartment and shifting the weight bearing axis to lateral compartment.