2017 ISAKOS Biennial Congress ePoster #1503

 

High Tibial Osteotomy Using Tomofix Plate. Long Terms Clinical and Radiological Results in Young Patients (Less than 40 Years Old)

Michael E. Hantes, MD, PhD, Prof., Larissa GREECE
Prodromos Natsaridis, MD, MSc, Agria Magnisias GREECE
Nikolaos Doxariotis, MD, Larisa GREECE
Panagiotis Karakitsios, MD, Larissa GREECE
Konstantinos N. Malizos, MD, Larisa GREECE

University Hospital of Larisa, Larisa, GREECE

FDA Status Not Applicable

Summary

RESULTS OF HIGH TIBIAL OSTEOTOMY FOR KNEE ARTHRITIS

Abstract

Purpose

We report on our experience in the treatment of osteoarthritis of the medial compartment of the knee with open wedge high tibia osteotomy (HTO) using the TomoFix plate in young patients (less than 40 years old).

Material And Method

Inclusion criteria were patients with symptomatic varus malalignment and medial compartment osteoarthritis aged between 20-40 years old, treated with HTO, and with a ,long-term (at least 10 years) follow-up. A total of 18 patients with a mean age of 35.4 years (28 to 39) were included in the study population. There were 16 men and 2 women. All patients underwent HTO using the TomoFix plate without any need for additional bone autograft or allograft . Patients were evaluated preoperatively as well as in the last follow-up, using the IKDC score, Oxford knee Score, and KOOS Score. Radiographs of the knee joint (ap and lateral view) and full weight-bearing long-leg anteroposterior radiographs were obtained at each examination to evaluate the mechanical tibiofemoral angle (mTFA), and the medial proximal tibia angle (MPTA)

Results

The mean follow-up was 12.3 years (from 10 to 16 years).Of the 18 patients who underwent this surgery between 2001 and 2005 only one patient had to be converted to total knee replacement. Therefore, the survival rate of the procedure was 95% in this long term follow-up. All clinical scores (IKDC, KOOS and Oxford knee score) showed a significant pre- to post-operative improvement at the last follow-up. The average values of the above scores were preoperatively/postoperatively were: for the KOOS 32.8 / 69.4, for the Oxford knee score 20.4 / 33.9, and for the IKDC 32.5 / 72,2. According to radiologic examination deformity correction was remained stable since the mean mFTA was -5.8°±2.4° preoperatively, and 2.2°±1.7° at the last follow-up.

Conclusions

According to our results, HTO with TomoFix plate is an effective method to treat medial compartment osteoarthritis in patients less than 40 years. Clinical and radiological results are satisfactory and the survival rate is 95%, 12 years after the procedure. Therefore we recommend this knee preservation procedure in these young patients since we can expect excellent knee function in the long-term.