Ghasemi SA, Zhang DT, Fragomen A, Rozbruch SR. Proximal tibial osteotomy for genu varum: Radiological evaluation of deformity correction with a plate vs external fixator. World J Orthop 2021; 12(3): 140-151 [PMID: 33816141 DOI: 10.5312/wjo.v12.i3.140]
Corresponding Author of This Article
S Ali Ghasemi, MD, Academic clinical Fellow, Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, 535 E 70th St, New York, NY 10021, United States. ghasemisar2@gmail.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Mar 18, 2021; 12(3): 140-151 Published online Mar 18, 2021. doi: 10.5312/wjo.v12.i3.140
Proximal tibial osteotomy for genu varum: Radiological evaluation of deformity correction with a plate vs external fixator
S Ali Ghasemi, David T Zhang, Austin Fragomen, S Robert Rozbruch
S Ali Ghasemi, David T Zhang, Austin Fragomen, S Robert Rozbruch, Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY 10021, United States
Author contributions: All authors contributed writing the paper and data collection.
Institutional review board statement: The study was reviewed and approved by Hospital for Special Surgery Institutional Review Board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: None of the authors has any conflict directly relating to the subject of study. Unrelated disclosures: Dr. Fragomen A is a consultant for Smith & Nephew, NuVasive and Synthes. Dr. Rozbruch SR is a consultant for NuVasive, Stryker, Smith & Nephew and Orthospin.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: S Ali Ghasemi, MD, Academic clinical Fellow, Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, 535 E 70th St, New York, NY 10021, United States. ghasemisar2@gmail.com
Received: May 23, 2020 Peer-review started: May 23, 2020 First decision: October 6, 2020 Revised: November 12, 2020 Accepted: February 11, 2021 Article in press: February 11, 2021 Published online: March 18, 2021 Processing time: 287 Days and 9.7 Hours
ARTICLE HIGHLIGHTS
Research background
High tibial osteotomy (HTO) for the correction of painful varus knee deformities is a known surgery. Different HTO techniques have been reported in the literature, including open and closed wedge osteotomies. In this study, the radiological efficacy of the gradual and acute correction of varus deformities with two different fixation methods (external fixator and plate screw) was evaluated.
Research motivation
We aimed to compare the radiological accuracy of the gradual correction of varus deformities with HTO with an external fixator and that of acute correction with a plate and screw.
Research objectives
The changes in radiological parameters (mechanical axis deviation, medial proximal tibial angle, posterior proximal tibial angle, joint line obliquity angle, Caton-Deschamps Index) were evaluated after both acute and gradual correction to determine the accuracy of correction achieved with the two techniques.
Research methods
Retrospective, nonrandomized study (level III).
Research results
Both acute correction (opening wedge and plate and screw) and gradual correction (external fixator) yield reliable degrees of correction of moderate varus alignment. The changes in the radiological parameters achieved with and accuracy of the two techniques are reasonable. There were changes in the patellar height after acute correction with a plate and screw.
Research conclusions
Both techniques (HTO with plate and screw and external fixator) are reliable for the correction of varus deformities, and external fixation may be a better choice when the preservation of patellar height is important.
Research perspectives
Studies with a larger number of patients and evaluations of the early and late clinical outcomes of both techniques are suggested.
