Intra-articular corrective osteotomies combined with the Ilizarov technique for the treatment of deformities of the knee.
OBJECTIVE
To present our experience of using a combination of intra-articular osteotomy and external fixation to treat different deformities of the knee.


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.


CONCLUSIONS
The use of intra-articular corrective osteotomies combined with the Ilizarov technique allowed correction of deformities of the knee joint with satisfactory HJLCA and overall mechanical axis in six patients with a good functional and cosmetic outcome in the short term. Cite this article: Bone Joint J 2017;99-B:204-10.
Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
J
J
Xu
Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Y
Y
Jia
Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Q
Q
Kang
Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Y
Y
Chai
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D018889:Ilizarov Technique; D016916:Joint Deformities, Acquired / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery*; D038061:Lower Extremity Deformities, Congenital / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D055815:Young Adult
Deformity; Ilizarov technique; Intra-articular corrective osteotomy; Knee