Proximal tibial biplane osteotomy with locking plate fixation for medial knee osteoarthritis

LIU Ze-peng; LI Chun-hong; RONG Shao-yuan; LI Jian-hua; YAO Zhi-jie; LI Ying-hui; HUANG Ye

doi:10.3969/j.issn.2095-252X.2016.12.006

Abstract：Objective To investigate the curative results of proximal tibial biplane osteotomy with TomoFix locking plate fixation for medial compartment knee osteoarthritis. Methods From October 2012 to June 2015, a total of 40 patients met our inclusion criteria. All the patients with medial compartment knee osteoarthritis were treated with proximal tibial biplane osteotomy and TomoFix locking plate fixation. The alteration of the femorotibial angle ( FTA ), visual analogue scale ( VAS ) and Insall-Salvati index was estimated preoperatively and postoperatively. Bone union and the appearance and management of complications were recorded. Results All the surgeries were successful. The mean FTA correction was ( 17.0 ± 2.3 ) ° ( range: 9° - 20° ). The mean preoperative VAS score was 7.5 ± 1.8 ( range: 4 - 10 ), and the mean postoperative VAS score was 1.8 ± 0.8 ( range: 1 - 4 ). The Hospital for Special Surgery ( HSS ) score was obviously improved. The mean preoperative HSS score was 58.6 ± 1.8 ( range: 55 - 62 ), and the mean postoperative HSS score was 81.6 ± 3.4 ( range: 77 - 86 ). There were no statistically significant changes in the patella height. Bone union was observed in all the patients. No deep incision, plate exposure or nerve injury occurred. An operative incision with superficial infection was found in 1 patient, which gradually healed after change of dressing. Conclusions Indications should be exactly mastered, which can guarantee the curative results. Good surgical techniques are critical for good clinical outcomes. A detailed plan before the operation and regulation of the line of traction in the operation are essential for the operation. The proximal tibial biplane osteotomy with locking plate fixation is efficient and safe for the medial compartment knee osteoarthritis.