High tibial osteotomy in medial compartment osteoarthritis and varus deformity using the Taylor spatial frame: early results

Abstract

We report the early results of high tibial osteotomy (HTO) in medial compartment osteoarthritis (OA) and varus deformity using the Taylor spatial frame (TSF). Between October 2005 and April 2007, 9 patients with medial compartment OA and varus deformity underwent TSF application and medial opening wedge HTO. Pre- and post-operative Oxford knee scores, SF-12 and visual analogue pain scores were recorded along with radiographic outcomes. Median follow-up was 19 months (range 15-35). Mean age at operation was 49 years (range 37-59). The median time spent in the frame was 18 weeks (range 12-37). The mean preoperative Oxford knee score was 28.7. This improved to a mean of 35.4 post-operatively (P = 0.0142). 6 (67%) patients had a documented pin-site infection. With TKR as an end point, the survival rate of HTOs was 88.9% at a median of 19 months follow-up. This study demonstrates that in selected patients the TSF provides a viable treatment option for performing HTO in medial compartment OA with varus deformity.

Fig. 1

Method of planning the magnitude of the opening wedge [32]. H hip, K knee, A ankle, VA virtual ankle, FP Fujisawa point. With kind permission from Springer Science + Business Media: Principles of deformity correction. Dror Paley. 2002. Chap. 16, p 493, figure 16-15b

Fig. 2

Fujisawa’s point (top) and the magnitude of MAD correction made according to the medial compartment joint space [33]. With kind permission from Springer Science + Business Media: Principles of deformity correction. Dror Paley. 2002. Chap. 16, p 481, figure 16-6

Fig. 3

Long leg standing AP radiograph post-correction

Fig. 4

Long leg standing AP radiographs demonstrating mechanical axis. a preoperatively, b post-correction