Year :
2021
| Month :
June
| Volume :
15
| Issue :
6
| Page :
RC01 - RC05
Full Version
Radiological and Functional Outcome of Medial
Tibial Reduction Osteotomy for Severe Varus
Deformity in Patients Undergoing Total Knee
Arthroplasty- A Prospective Cohort Study
Published: June 1, 2021 | DOI: https://doi.org/10.7860/JCDR/2021/47283.14972
Amal Mathew, AS Arun Kumar, Murukan Babu, TC Ranjith, Susan John
1. Resident, Department of Orthopaedics, Rajagiri Hospital, Aluva, Kerala, India.
2. Associate Professor, Department of Orthopaedics, Travancore Medical College, Kollam, Kerala, India.
3. Senior Consultant, Department of Orthopaedics, Rajagiri Hospital, Aluva, Kerala, India.
4. Senior Consultant, Department of Orthopaedics, Rajagiri Hospital, Aluva, Kerala, India.
5. Consultant Epidemiologist, Department of Clinical Epidemiology, Rajagiri Hospital, Aluva, Kerala, India.
Correspondence Address :
Dr. AS Arun Kumar,
Ambadi Sadan, Keralapuram, Vellimon P.O. Kollam-691511, Kerala, India.
E-mail: arun.acme8.kottayam@gmail.com
Abstract
Introduction: The deformity and imbalance in an osteoarthritic knee undergoing Total Knee Arthroplasty (TKA) are the result of a combination of bony and soft tissue changes locally. Proper and ideal balancing of ligaments is considered essential to the success of a TKA. There are numerous techniques to achieve soft tissue balance in varus knee. More recently, Medial Tibial Reduction Osteotomy (MTRO) has been described as an adjuvant to soft tissue release. Limited data exists on the outcomes of patients requiring a MTRO. There are not many Indian studies available regarding the radiographic and clinical outcomes of medial reduction osteotomy in severe varus deformity in TKA.
Aim: To find out the radiological and functional outcome of MTRO for severe varus deformity in patients undergoing TKA.
Materials and Methods: This study was prospective Cohort study conducted at the Department of Orthopaedics, Rajagiri Hospital, Chunangamveli, Aluva, Kerala from December 2018 to November 2019. Twenty patients 15 females and 5 males (30 knees), in the age group 55-80 years with osteoarthritis of knee with severe varus deformity, were enrolled in the study. Preoperative and postoperative standing leg Antero-posterior radiographs were taken for all patients and hip-knee-ankle angle was measured and amount of deformity correction was calculated. Postoperatively, radiographs were taken on the 5th day and 3rd month. Knee society scores were also recorded preoperatively and on the 5th postoperative day, postoperative visits on 6 weeks, 3 months and clinical outcome was assessed. The statistical analysis was performed by Statistical Package for Social Sciences (SPSS) version 25.0 using Analysis of Variance (ANOVA) and Wilcoxon Signed Rank test.
Results: The median knee score improved from 47±9 to 93±3 postoperatively. Similarly, median function score improved from 50±5 to 80±0. The improvement in function score and knee score were statistically significant (p-value 0.001). The correction of varus between preoperative, postoperative (p-value 0.001) day 5 and 3 months postoperatively was statistically significant. No patient required a release of the superficial Medial Collateral Ligament (MCL). The MTRO was associated with statistically significantly improved Knee Society scores and varus deformity correction.
Conclusion: In patients with fixed varus deformity of the knee, the MTRO is found to be safe and adequate to achieve coronal alignment.
Keywords
Knee society score, Ligament balancing, Medial tibial osteophytes, Medial collateral ligament
10.7860/JCDR/2021/47283.14972
Date of Submission: Oct 20, 2020
Date of Peer Review: Dec 25, 2020
Date of Acceptance: Apr 08, 2021
Date of Publishing: Jun 01, 2021
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Oct 21, 2020
• Manual Googling: Mar 15, 2021
• iThenticate Software: Apr 27, 2021 (25%)
ETYMOLOGY: Author Origin
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