Knee Surg Relat Res.  2014 Jun;26(2):88-96. 10.5792/ksrr.2014.26.2.88.

Corrective Tibial Osteotomy in Young Adults Using an Intramedullary Nail

• Kim KI
• Thaller PH
• Ramteke A
• Lee SH
• Lee SH

• KMID: 2223284
• DOI: http://doi.org/10.5792/ksrr.2014.26.2.88

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 -9.7degrees preoperatively to 1.1degrees 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.

Keyword

Knee; Tibia; Varus; Young adult; Corrective osteotomy; Intramedullary nailing

MeSH Terms

Congenital Abnormalities
Follow-Up Studies
Fracture Fixation, Intramedullary
Humans
Knee
Osteotomy*
Prospective Studies
Tibia
Transplants
Young Adult*