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Khirurgii

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Year 2015 Vol. 23 No 6

TRAUMATOLOGY & ORTHOPEDICS

A.A. ZYKIN, N.A. TENILIN, A.A. KORYTKIN, S.A. GERASIMOV

A NEW METHOD FOR OSTEOTOMY OF THE TIBIA FOR AXIAL DEFORMITY CORRECTION OF THE LOWER EXTREMITIES

FSBE "Privolzhsky Federal Research Medical Centre" of the Ministry of Health of the Russian Federation
The Russian Federation

Objectives. To develop a new method of osteotomy of the tibia for axial deformity correction of the lower extremities and to evaluate the results of its application in patients with gonarthrosis at the front deformities greater than 15 degrees.
Methods. The treatment results of 27 patients (aged up to 60 yrs) with gonarthrosis stage II-III who were underwent to corrective osteotomy near the knee joint have been studied. The method of corrective tibia osteotomy was applied in 13 patients (48%) with gonarthrosis stage II-III at a varus deformity of the lower extremities exceeding 15 degrees. The treatment results of the patients with knee gonarthrosis stage II-III assessed using a 100-point Josef and Kaufman scale. The results were evaluated within the monitoring periods of 3, 6, 12, 18 and 24 months.
Results. By using an in-house developed method the high values on the scale of Joseph & Kaufman (61 to 84,5 points) have been obtained corresponding to the results of analogous opening-wedge osteotomies (p>0,1 within a 24-month monitoring period). The best results after 6 months of monitoring were registered in the group of patients operated on by a new technique (p<0,037). The proposed method retaining all the advantages of high osteotomy (rapid and lower impact of consolidation) eliminates the tension of the patellar ligament, allows correcting the axial deformity of an axis shift of more than 15 degrees and ultimately permits patients quickly begin restoring the initial level of physical activity.
Conclusion. The proposed method of corrective osteotomy may be recommended for the normalization of the mechanical axis of a lower extremity in patients with knee gonarthrosis stage II-III and front deformities exceeding 15 degrees. This technique was applied for treatment of 13 patients with obtaining good results.

Keywords: knee joint, gonarthrosis, axial strain, corrective osteotomy, high tibial osteotomy, stages, physical activity
p. 651-657 of the original issue
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Address for correspondence:
603155, Russian Federation,
Nizhny Novgorod, Verhnevolzhskaya naberezhnaya, d. 18,
FGBU "Privolzhskiy federalnyiy meditsinskiy
issledovatelskiy tsentr", tel.: 831 436-01-60,
e-mail: dr.zykin@mail.ru,
Zykin Andrey Anatolevich
Information about the authors:
Zykin A.A. A junior researcher of the orthopedics department (the adults) of FSBE "Privolzhsky Federal Research Medical Centre" of the Ministry of Health of the Russian Federation.
Tenilin N.A. MD, a leading researcher of pediatric orthopedics department of FSBE "Privolzhsky Federal Research Medical Centre" of the Ministry of Health of the Russian Federation.
Korytkin A.A. PhD, a head of the orthopedics department (the adults) of FSBE "Privolzhsky Federal Research Medical Centre" of the Ministry of Health of the Russian Federation.
Gerasimov S.A. A traumatologist-orthopedist of the orthopedics department (the adults) of FSBE "Privolzhsky Federal Research Medical Centre" of the Ministry of Health of the Russian Federation.
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