Aims. To present our experience of using a combination of intra-articular
osteotomy and external fixation to treat different deformities of
the knee. Patients and Methods. A total of six patients with a mean age of 26.5 years (15 to
50) with an abnormal hemi-joint line convergence angle (HJLCA) and
mechanical axis deviation (MAD) were included. Elevation of a tibial
hemiplateau or femoral condylar advancement was performed and limb
lengthening with correction of residual deformity using a circular
or monolateral Ilizarov frame. Results. At a mean follow-up of 2.8 years (1.5 to 4.1), the mean HJLCA
improved from 15.6° (10° to 23°) pre-operatively to 0.4° (0° to
2°). The mean MAD improved from 70.0 mm (20.1 to 118.5) pre-operatively
to 9.1 mm (3 to 15). The mean tibiofemoral angle improved from 31.0°
(8° to 54°) pre-operatively to 4.9° (2° to 8°). The mean limb-length discrepancy
decreased from 6.3 cm (2.9 to 13.6) pre-operatively to 1.1 cm (0
to 5). All osteotomies and distraction zones healed without complications. Conclusion. The use of intra-articular corrective osteotomies combined with
the
We retrospectively evaluated eight patients who underwent arthrodesis of the knee using cannulated screws. There were six women and two men, with a mean age of 53 years. The indications for arthrodesis were failed total knee arthroplasty, septic arthritis, tuberculosis, and recurrent persistent infection. Solid union was achieved in all patients at a mean of 6.1 months. One patient required autogenous bone graft for delayed union. One suffered skin necrosis which was treated with skin grafting. The mean limb-length discrepancy was 3.1 cm. On a visual analogue scale, the mean pain score improved from 7.9 to 3.3. According to the Knee Injury and Osteoarthritis Outcome score quality of life items, the mean score improved from 38.3 pre-operatively to 76.6 at follow-up. Cannulated screws provide a high rate of union in arthrodesis of the knee with minimal complications, patient convenience, and a simple surgical technique.
