2007, Number 2
<< Back Next >>
Rev Med Inst Mex Seguro Soc 2007; 45 (2)
High Tibial Dome Osteotomy Complications in Genu Varum Patients
King-Martínez AC, Cuéllar-Avaroma A, Pérez-Correa J, Torres-González R, Guevara-López U
Language: Spanish
References: 18
Page: 111-116
PDF size: 165.54 Kb.
ABSTRACT
Objective: to identify if pre-chirurgical risk factors or the surgical technique were associated with the complications of the osteotomy in genu varus patients.
Methodology: a case-control study was conducted in patients that underwent Maquet proximal tibial osteotomy for treatment of genu varus between January and December 2003. The risk factors were the following: age 50 or more years old, comorbidity such as type 2 diabetes, hypertension, rheumatoid arthritis, overweight and obesity (BMI ≥ 25 and ≥ 30), duration of ischemia longer than 60 min and local pain. Cases were those who developed one or more complications. Descriptive and inferential statistical analyses were performed.
Results: one hundred and thirty-four patients were included, among which 53 % had complications. None of the risk factors were statistically significant (p › 0.05).
Conclusions: none of pre-chirurgical risk factors were associated with the complications of osteotomy; therefore, these could be attributable to the surgical technique. It is necessary to outweigh the temporary benefits of the tibial osteotomy versus the increase in the risk of complications when performing total knee arthroplasty.
REFERENCES
Maquet P. The treatment of choice in osteoarthritis of the knee. Clin Orthop Relat Res 1985; Jan-Feb:108-112.
Kharrazi D, Chandler RW, Spitzer AI. High tibial osteotomy for the treatment of unicompartmental arthritis of the knee. Curr Opin Orthop 2000;11(1):26-34.
Hsu RW. The study of Maquet dome high tibial osteotomy, arthroscopic-assisted analysis. Clin Orthop Relat Res 1989;Jan:280-285.
Insall JN, Joseph DM, Msika C. High tibial osteotomy for varus gonarthrosis. A long-term follow-up study. J Bone Joint Surg Am 1984;66 (7):1040-1048.
Kadambande SS, Auyeung J, Ghandour A, Mintowt-Czyz W. A review of wound healing following Maquet osteotomy. Knee 2004;11(6): 463-467.
Aydogdu S, Cullu E, Arac N, Varolgunes N, Sur H. Prolonged peroneal nerve dysfunction alter high tibial osteotomy pre- and postoperative electrophysiological study. Knee Surg Sports Traumatol Arthrosc 2000;8(5):305-308.
American Academic of Orthophedic Surgeons. Nonunion after high tibial osteotomies. Orthopaedic short stories. US: AAOS; 2000.
Hyman J, Moore T. Anatomy of the distal knee joint and pyarthrosis following external fixation. J Orthop Trauma 1999;13(4):241-246.
DeCoster TA, Crawford MK, Kraut MA. Safe extracapsular placement of proximal tibia transfixation pins. J Orthop Trauma 1999;13(4):236-240.
Adili A, Bhandari M, Giffin R, Whately C, Kwok DC. Valgus high tibial osteotomy. Comparison between an Ilizarov and a Coventry wedge technique for the treatment of medial compartment osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc 2002;10(3):169-176.
Naudie D, Bourne RB, Rorabeck CH, Bourne TJ. Survivorship of high tibial valgus osteotomy. A 10 to 22 year follow up study. Clin Orthop Relat Res 1999;367:18-27.
Virolainien P, Aro HT. High tibial osteotomy for treatment of osteoarthritis of the knee: a review of the literature and a meta-analysis of follow-up studies. Arch Orthop Trauma Surg 2004;124(4):258-261.
Sprenger TR, Doerzbacher JF. Tibial osteotomy for the treatment of varus gonarthrosis. Survival and failure analysis to twenty-two years. J Bone Joint Surg Am 2003;85(3):469-474.
Aglietti P, Buzzi R, Vena LM, Baldini A, Mondaini A. High tibial valgus osteotomy for medial gonarthrosis: a 10- to 21-year study. J Knee Surg 2003;16(1):21-26.
Huang TL, Tseng KF, Chen WM, Lin RM, Wu JJ, Chen TH. Preoperative tibiofemoral angle predicts survival of proximal tibial osteotomy. Clin Orthop Relat Res 2005;432:188-195.
Windsor RE, Insall JN, Vince KG. Technical Considerations of total knee arthroplasty after proximal tibial osteotomy. J Bone Joint Surg 1988;70-A(4):547-555.
Krackow KA, Holtgrewe JL. Experience with a new technique for managing severely overcorrected valgus high tibial osteotomy at total knee artroplasty. Clin Orthop Relat Res 1990; 258:213-224.
Haddad FS, Bentley G. Total knee arthroplasty after high tibial osteotomy: a medium-term review. J Arthroplasty 2000;15(5):597-603.