USE OF TOMOFIX PLATE IN HIGH TIBIAL OSTEOTOMY FOR MEDIAL COMPARTMENT OSTEOARTHRITIS OF THE KNEE

Abstract

Introduction: The aim of this study was to determine the outcome of Tomofix plate fixation, in joint retaining surgery, for Medial compartment Osteoarthritis of the knee in young patients

Methods: We report on 33 patients (36 knees) who underwent High tibial osteotomy for unicompartmental osteoarthritis of the knee. The mean age was 39.5 (30–49). There were 20 males and 13 female. All the patients had Medial opening-wedge type Osteotomy using the Tomofix device. The mean duration of follow-up was 48 months (44–60 months). The patients were assessed on the basis of pre and post-operative oxford knee score, knee range of motion, radiological evidence of healing of the osteotomy site and alignment of the knee.

Results: There were no nonunions at the osteotomy site and the medial open-wedge filled-in without any need for bone graft or its substitutes. The mean preoperative oxford knee score was 48 (S.D 4.7 Range 38–54). This improved to a mean score of 22 (S.D 5.9 Range 17–31) after 1 year follow-up. The improvement was significant (pvalue= 0.07). The preoperative average knee flexion was 103.1 (S.D 25.2 Range 10–125) which improved after 1 year follow up to 112 (S.D 15.9 Range 0–140). The mean preoperative Femorotibial angle was 10 degrees varus (range 9–15). The mean postoperative Femorotibial angle was 8 deg valgus (range 6–12). Radiologically, there was no loss of correction during our follow-up. One patient had post-operative DVT.

Conclusion: Our study shows that Tomofix plate fixation in High Tibial osteotomy gives immediate stability, good deformity correction and allows early rehabilitation. The osteotomy gap does not require bone grafting and the correction is maintained. The Short term functional results are encouraging. Longer-term follow-up is however needed to establish its effectiveness in deferring joint replacement surgery in young patients.