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The Bone & Joint Journal
Vol. 104-B, Issue 11 | Pages 1273 - 1278
1 Nov 2022
Distal tibial osteotomy compared to proximal osteotomy for limb lengthening in children
Chowdhury JMY Ahmadi M Prior CP Pease F Messner J Foster PAL
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Aims

The aim of this retrospective cohort study was to assess and investigate the safety and efficacy of using a distal tibial osteotomy compared to proximal osteotomy for limb lengthening in children.

Methods

In this study, there were 59 consecutive tibial lengthening and deformity corrections in 57 children using a circular frame. All were performed or supervised by the senior author between January 2013 and June 2019. A total of 25 who underwent a distal tibial osteotomy were analyzed and compared to a group of 34 who had a standard proximal tibial osteotomy. For each patient, the primary diagnosis, time in frame, complications, and lengthening achieved were recorded. From these data, the frame index was calculated (days/cm) and analyzed.

Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_III | Pages 362 - 362
1 Mar 2004
O3263 FUNCTIONAL OUTCOME OF TIBIAL OPEN WEDGE OSTEOTOMIES (GOUTALLIER-HERNIGOU TYPE) PERFORMED IN BORDERLINE OR SEVERE (REQUIERING TKR) CASES OF GONARTHROSIS (OSTEOARTHRITIS OF THE KNEE)
Mihailide N Dragosloveanu C Rotarus N Ahmadi M
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Aim: The purpose of this study is to establish if there is any or no beneþt in performing an opening wedge tibial osteotomy (TO) in patients normally requiering a total knee replacement (TKR). Methods: A group of 70 patients having been initially diagnosed with a form of osteoarthritis of the knee that would normally coun-terindicate an osteotomy (age over 65, stages, Ahlback III or IV, presence of patello-femoral arthritis) but in which other factors (associated pathology, age under 40, hard physical labour) did not allow as to perform a total replacement of the joint and who þnally underwent a T.O. (using an acrylic cement spacer) was followed-up for a mean period of 6.5 year both clinically (using 2 functional scores) and radiologically.

In all patients weight-bearing AP radiographs taken preoperatively showed a degree of varus malalignement. Results: Only 5 patients from the initial group required a TKR during the follow-up period. In most cases results were good regarding painless motion and activity and satisfactory regarding the amplitude of movement, even in cases with no radiological improvements. Conclusion: We consider that opening wedge osteotomy may still represent a valuable solution in treating severe cases of osteoarthritis of the knee in which T.K.R. is not possible due to various reasons, also bearing in mind that is far more easy to perform a TKR after an opening wedge osteotomy than after a closing wedge technique.