Gradual correction of idiopathic genu varum deformity using the Ilizarov technique

Department of Orthopaedic Surgery, Institute for Rare Diseases, Korea University Medical Center, Guro Hospital, 80, Guro-Dong, Guro-Gu, Seoul, 152-703, Korea, .
Knee Surgery Sports Traumatology Arthroscopy (Impact Factor: 3.05). 06/2012; 21(7). DOI: 10.1007/s00167-012-2074-7
Source: PubMed


PURPOSE: Proximal tibial osteotomy is an effective treatment option for genu varum deformity among the many other described techniques. The purpose of this study is to evaluate the clinical and radiological outcomes and the complications in gradual correction of idiopathic genu varum deformity using Ilizarov frame. METHODS: Proximal tibial medial opening wedge osteotomy was performed in 21 lower limbs of 11 patients, with whom the Ilizarov external fixator was used for gradual correction of the varus deformity. The mean age of the patients was 24.8 years (SD, 5.3). Deformity measurements of conventional mechanical axis deviation, mechanical medial proximal tibial angle, mechanical lateral distal femoral angle, posterior proximal tibial angle, joint conversion angle, tibio-femoral angle and tibial slope were compared. RESULTS: The mean time for removal of the Ilizarov fixator was 24.7 weeks. At the last follow-up, the mean of Hospital for Special Surgery knee score increased, and the mean mechanical medial proximal tibial angle, tibio-femoral angle and conventional mechanical axis deviation improved. The differences between preoperative and postoperative posterior proximal tibial angle, mechanical lateral distal femoral angle, joint conversion angle and tibial slope were not significant. Ten complications were observed, of which 8 were minor complications and 2 were minor complications. CONCLUSION: With a few complications, normal alignment and orientation of lower extremity can be established in patients with idiopathic genu varum deformity through gradual correction using a Ilizarov fixator. LEVEL OF EVIDENCE: Retrospective case series, Level IV.

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    ABSTRACT: High tibial osteotomy methods include open and closed wedge techniques. The study aims at comparing results of osteotomy methods in patients suffering from genu varum deformity. In a cohort study, 32 patients with genu varum deformity (42 knees) were evaluated. They were divided into two groups and matched according to age and gender. The patients were treated with open and closed wedge osteotomy. After surgery, they were followed up and compared for 6 months. Thirty two patients with genu varum deformity (10 cases of bilateral deformity (31.2%) including 25 women (87.2%) and 7 men (21.8%) were studied. Incidence of complications was the same after open and closed wedge osteotomy operation (12.5%). Patients overall satisfaction from open and closed wedge methods was 87.5 and 75%, respectively. There was statistically significant difference between two groups considering operation duration, weight bearing duration and return to routine activities (p < 0.001). There was no difference in other parameters including varus angle correction, Lysholm score Tegner activity as well as Insall Salvati index. This study demonstrated that there is no difference between two osteotomy methods considering patients' clinical outcomes and both methods are successful in final treatment results.
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