Abstract
Objective
Stable correction of a varus knee with osteoarthritis of the medial and patellofemoral compartments through a high tibial valgization osteotomy.
Indications
Painful osteoarthritis of the medial compartment with or without patellofemoral involvement in patients with varus knee.
Contraindications
Osteoarthritis of the lateral compartment.
Varus exceeding 15° and flexion deformity exceeding 10°.
Severe limitation of movement.
Instability of knee.
Uncooperative patient.
Surgical Technique
Transverse lateral approach. Resection of proximal tibiofibular joint. Lateral wedge resection osteotomy, leaving an anterior bony ledge at the distal and a posterior ledge at the proximal fragment (box osteotomy). Anterior translation of distal fragment. Fixation with stepped staple. Cylinder cast for 6 weeks.
Results
Report on 16 patients (nine women, seven men, age 48–64 years) with a minimum follow-up of 30 months (maximum 6 years). Using the Hospital for Special Surgery (HSS) knee-score, 93.75 of the patients had either an excellent or good result. The outcome was fair in one patient only. A longitudinal assessment using the HSS score showed a reduction in the mean score over the period of reporting.
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Agarwala, S., Sinha, M. & Parasnis, R.N. Box Osteotomy — a New Technique of Proximal Tibial Osteotomy for Osteoarthritis of the Knee. Orthop Traumatol 9, 218–227 (2001). https://doi.org/10.1007/s065-001-8356-x
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DOI: https://doi.org/10.1007/s065-001-8356-x