Functional Evaluation of Barrel Vault Tibial Osteotomy for Medial Compartmental Osteoarthritis of the Knee RC05-RC08
Dr. Deepak Sadashiv Phalgune,
18/27, Bharat Kunj-1 Erandawane, Pune-411038, Maharashtra, India.
Introduction: Degenerative changes in articular cartilage of diarthrodial joints and subsequent new bone formation at articular margin are caused due to aging. This leads to osteoarthritis. Most commonly affected joint is the knee. High tibial osteotomy is one of the treatments of isolated osteoarthritis of medial tibiofemoral compartment of knee.
Aim: To evaluate functional outcome of barrel vault tibial osteotomy in management of osteoarthritis of knee.
Materials and Methods: The present prospective study was conducted in Poona Hospital and Research Centre, between May 2012 and May 2015. Fifty patients of either sex in age group 45 to 60 years with suspicion of medial compartmental osteoarthritis knee and out of these who were ready to participate were included in the study. Arthroscopy of knee was performed to confirm the diagnosis of osteoarthritis knee and to exclude the diagnosis of lateral compartmental osteoarthritis knee. Patients were treated with barrel vault tibial osteotomy. Postoperatively, patients were evaluated by HKA angle, Knee Society Score, Visual Analogue Scale to measure the outcome. Fisherâ€™s-exact test, paired t-test and ANOVA test were used to study the statistical significance.
Results: There was significant improvement (p < 0.001) in mean HKA angle, knee score (from 48.10 preoperatively to 86.14 postoperatively), mean functional score (from 58.60 preoperatively to 93.40 postoperatively) postoperatively at six month follow up. There was significant difference between mean HKA angle, mean functional score and mean range of motion with respect to functional outcome. In all 47/50 (94%) patients had excellent or good functional outcome. Relief of patellofemoral symptoms were because of Maquet effect.
Conclusion: Barrel vault tibial osteotomy in the management of medial compartmental osteoarthritis of the knee is useful in patients between 45 and 60 years of age.