Corrective osteotomies in the treatment of lower limb deformities in deforming osteoarthritis of the knee joint

Abstract

The paper presents the medium-term results of the use of periarticular osteotomies of the tibia and femur in the treatment of deforming knee arthrosis (KA) against the background of lower limb deformities. The aim of the study was to evaluate the effectiveness of osteotomy combined with one-stage endoscopic organ-sparing interventions in the treatment of gonarthrosis. The object of the study was 74 patients with deforming osteoarthritis (DOA) of KA II-III degrees. Selection criteria: changes in the load axis of the limb in the frontal and sagittal planes, degenerative changes of the joint predominantly in one department (medial, lateral), the presence of contracture not more than 10˚. The study group did not include patients with degenerative damage to two parts of the knee joint, pronounced patellofemoral arthrosis, and flexion contracture of more than 10°. Preoperative planning and selection were performed on the basis of clinical examination, radiography, MRI, and CT scan data. Surgical treatment was performed in one surgical session: when correcting a varus deformity, osteotomy was performed first, and arthroscopic intervention, including ligament plasty, was performed second; when correcting a valgus deformity with femoral osteotomy, primary KA arthroscopy followed by osteotomy was optimal. As a result of the treatment, excellent and good results were achieved in the majority of patients in the medium-term period.