Corrective Tibial Osteotomy in Young Adults Using an Intramedullary Nail

Overview

Journal Knee Surg Relat Res

Publisher Biomed Central

Date 2014 Jun 20

PMID 24944974

Citations 2

Authors

Kang-Il Kim

Peter H Thaller

Alankar Ramteke

Sang Hak Lee

Seung-Hyuk Lee

Affiliations

Soon will be listed here.

Abstract

Purpose: The purpose of this study was to document results of a less invasive technique of open wedge proximal tibial osteotomy (PTO) for the varus knee in young adults using an intramedullary tibial nail.

Materials And Methods: We prospectively studied 24 knees in 16 young patients with varus knee deformity. The mean follow-up was 54 months (range, 36 to 107 months) and the mean age of patients at the time of operation was 25.8 years (range, 18 to 40 years). The open wedge PTO was performed below tibial tuberosity using a percutaneous multiple drill-hole technique. Conventional intramedullary tibial nail was used for fixation without bone graft. Radiographic evaluations were made using mechanical alignment (MA), posterior tibial slope angle, and Insall-Salvati ratio. Union time, loss of correction, implant failure, and associated complications were also investigated.

Results: The mean MA was significantly changed from -9.7° preoperatively to 1.1° at the final follow-up (p<0.001). There was no significant change in the proximal tibial anatomy and patellar height. All patients achieved radiographic bony union at an average of 3.1 months without loss of correction. The only complication was knee pain due to nail prominence in 3 patients.

Conclusions: Radiographic evaluation indicated that PTO using an intramedullary tibial nail leads to significant improvement in radiographic parameters without changes in posterior tibial slope or patellar height. We found that this technique could be a less invasive and effective alternative for correction of the varus knee in young adults.

Citing Articles

Avoiding Compartment Syndrome, Vascular Injury, and Neurologic Deficit in Tibial Osteotomy: An Observational Study of 108 Limbs.

Hoellwarth J, Geffner A, Fragomen A, Reif T, Rozbruch S J Am Acad Orthop Surg Glob Res Rev. 2023; 7(11).

PMID: 37973030 PMC: 10656085. DOI: 10.5435/JAAOSGlobal-D-23-00075.

Carbon-Fiber-Reinforced Polymer Intramedullary Nails Perform Poorly in Long-Bone Surgery.

Fragomen A, Teplensky J, Rozbruch S HSS J. 2019; 15(2):109-114.

PMID: 31327940 PMC: 6609670. DOI: 10.1007/s11420-018-9634-4.

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