Tibial condylar valgus osteotomy was more efficacious treatm
A Study was conducted to compare the clinical outcomes and the radiographic features between tibial condylar valgus osteotomy (TCVO) and open wedge high tibial osteotomy (OWHTO).

63 knees with medial-compartment osteoarthritis were retrospectively studied. 34 knees with subluxated lateral joint and depression of the medial tibial plateau underwent TCVO and the rest underwent OWHTO. Among the 63 knees included, 27 knees with a pre-operative femorotibial angle (FTA) more than 185° were defined as severe varus. Lower limb alignment, intra-, and extra-articular congruency were evaluated according to the radiograph obtained before and 24 months after surgery. Opening angle and distance of the opening gap in each group were measured by intra-operative fluoroscopy.

Results:
--During the 2-year follow-up period, the mean HSS score increased from 70.3 to 81.4 in HTO group and 65.9 to 87.3 in TCVO group.

--The mean VAS score decreased from 5.9 to 2.6 and 6.0 to 2.1, respectively.

--Pre-operative FTA was restored to 172.9° in HTO group and 171.3° in TCVO group, and percentage of mechanical axis was improved to 59.7% and 61.2%, respectively.

--Joint line convergence angle (JLCA) was slightly restored and medial tibial plateau depression (MTPD) was relatively the same before and after OWHTO, while these parameters improved greatly (from 6.4° to 1.2° and 8.0° to 5.9°) in TCVO group.

--More undercorrected knees were observed in SHTO group than STCVO group (58.3% and 13.3%). Opening angle and distance of the opening gap were larger in TCVO group (19.1° and 14.0 mm) than those in OWHTO group (9.3° and 10.1 mm).

TCVO finally prioritized the treatment of advanced knee OA with intra-articular deformity compared with OWHTO. But TCVO's ability to correct the varus angle was limited. TCVO could also be appropriate for OA medial-compartment with more than 185° preoperative FTA.

Source: https://josr-online.biomedcentral.com/articles/10.1186/s13018-021-02597-x
Like
Comment
Share