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Natl J Med Res. 2012; 2(2): 214-217

Medial Open Wedge High Tibial Osteotomy for Varus Arthritic Knees by Dynamic External Fixator System (Distraction Callotasis)

Shah Mukesh N, Amin Richa P, Patel Kunal C, Amin Prakash V, Pandit Jyotindra P.

Introduction: Varus arthritic knee is a major disabling condition in a relatively younger individual. Fixator assisted medial open wedge osteotomy has been found to be a good modality of treatment with promising results.
Material & methods: In last 6 years total 52 patients with varus arthritic knee were treated with medial open wedge HTO fixed with external fixator and gradual distraction. The required degree of correction was calculated pre-operatively on a long axis weight bearing films. Distraction of Osteotomy was started at 1 week post operatively and continued till desired degree of correction was achieved. Patients were assessed clinically and radiologically by check X-rays periodically. Fixator was removed after satisfactory consolidation of osteotomy site on x-ray and results were assessed. The follow-up ranged from 3 months to maximum of 6 years.
Results: Excellent pain relief was obtained in 43 patients out of 52. Four patients had good pain relief and 3 patients were not satisfied and had persistent symptoms. One patient had loss of correction after removal of fixator and 1 had over-correction. Pin-tract infection was found in 2 patients. None of the patients had non-union of osteotomy or conversion to TKR till last follow-up.
Conclusion: Medial open wedge osteotomy with dynamic external fixator has many advantages over other modalities of treatment with promising results. It gives life to varus arthritic knees in younger individuals.

Key words: Medial Open Wedge, HTO-Ex Fix, Tibia, Osteoarthritis, Total knee replacement

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