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Year : 2016  |  Volume : 2  |  Issue : 2  |  Page : 94-101

Can fixator-assisted plating of focal dome osteotomy accurately correct varus deformity in medial compartment osteoarthritis?

Department of Orthopaedic Surgery, Centre for Ilizarov Techniques, Chaudhary Hospital, Akola, Maharashtra, India

Correspondence Address:
Milind M Chaudhary
Centre for Ilizarov Techniques, Chaudhary Hospital, Civil Lines, Akola - 444 001, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2455-3719.190711

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Large varus deformities in medial compartment osteoarthritis are difficult to correct with lateral closing-wedge or medial opening-wedge osteotomies. They are easier to correct gradually with opening-wedge or dome osteotomies with external fixation. A focal dome osteotomy can support a large angular correction and yet retains good bony contact. It creates a large proximal fragment that allows for better fixation. However, external fixation devices are cumbersome and not well tolerated by older women and those who cannot follow-up over long distances. Fixator-assisted plating of the focal dome osteotomy combines the advantages of the fixator for accuracy of correction and the convenience of the locking plate. We retrospectively analyzed 34 focal dome high-tibial osteotomies in 31 patients performed over 6 years. Preoperative mechanical axis deviation was −19% (−150%-28%) which improved to 55% (3%-108%). The average preoperative medial proximal tibial angle was 79.8° (88°-63°) which improved to 93° (84°-107°). The average preoperative hip-knee-ankle angle was 195.2° (185°-225°) which improved to 177.5° (166°-204°). Femorotibial angle was 184.6° (182°-220°) which improved to 172° (158°-184°). The tibial slope reduced from 76.9° to 81.1°. Average follow-up was 70 months (45-113). Large varus deformities could be corrected safely with reasonable accuracy in this study.

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