Preoperative and postoperative radiomorphological changes in the bones forming the knee joint of patients with tibial shortening and deformities of different etiology

Abstract

Introduction. Tibial lengthening is one of highly popular surgical procedures that can be associated with complications of the knee joint related to surgical intervention or baseline changes in the bones forming the knee. Objective. To explore preoperative and postoperative changes in the bones forming the knee joint of patients with tibial shortening of different etiology. Material and methods. Radiography and multislice computed tomography (MSCT) were performed for 48 achondroplasia patients, 15 subjects with subjectively low height, 25 patients with vitamin-D resistant rickets (MRI produced for 20 patients), 56 patients with Blount’s disease (MSCT produced for 10 cases) before and after tibial lengthening or deformity correction. Results. The findings showed that tibial lengthening was accompanied by limited function of the knee even in absence of evident articular changes. Good results could be ensured with adequately performed lengthening technique and proper control of muscle condition and rehabilitation program to be meticulously followed. Patients with baseline problems in the joints were shown to have progressive changes in the knee joints during tibial lengthening, however, they were not critical and could provide a normal function at a long-term follow-up. Conclusion. Tibial lengthening as a complicated biomechanical and morphological process is accompanied by changes in the knee joint and can be successfully accomplished with adequate technique applied and rehabilitation program performed. Chnages in the knee were more evident in patients with baseline disorders in the anatomy and architechtonics of the femoral and tibial condyles, however, improved biomechanical parameters of the limb allowed us to obtain positive outcomes and good function in almost all the cases.