KNEE OSTEOARTHRITIS WITH VARUS DEFORMITY – TIBIAL OSTEOTOMY

Male 48 years with varus deformation of the knees – varus knees – and osteoarthritis in the medial joint compartment. The patient reports intense pain on the inner side of the knee (medial compartment), which occurs during performance of daily activities and in rest (night pain).
In clinical control, pain found on the inner side of the knee due to severe osteoarthritis has been developed despite the age of the patient. Also the knee shows a reduced range of motion (reducing the extent of the knee).
The patient has difficulties during his professional activities due to the increasing knee pain that worsens at the end of the year.
In standing position we observe the deformation of the knees.

Male 48 years old with varus knees (especially right lower limb). The mechanical axis of the limb is affected seriously by creating a vicious cycle instructed the overload in the inner side of the knee (medial compartment) and occurrence of early degenerative osteoarthritis in a relatively young age.

Radiological control of knee reveals the problem of arthritis in the medial knee compartment. The evaluation of the mechanical axis of the lower limbs is considered necessary.

Medial compartment osteoarthritis in varus knees

The MRI reveals damage of the articular cartilage and the state of meniscus and soft tissue

The measurement of the mechanical axis of the lower limb during the surgery and with the help of X-ray machine it is necessary to correct this (red line is the rod which controls the correction of the mechanical axis intraoperatively)

Special plate for the correction of the varus knee.  In bone gap placed the autografts and synthetic graft    

X-ray imediatelly post-op

Functional knee brace after operation

Two months after surgery the mechanical axis of the right leg is fully corrected (straight red line)

X-ray 3 months post-op

Three months after surgery. The mechanical axis of the lower end is fully restored.

The target of the corrective osteotomy for treating varus knee in conjunction with the occurrence of arthritis is to displace and redistribute the loads applied on the inside of the knee (medial compartment) and to the outer side (lateral compartment) and to relieve thus the audible symptoms of pain in the joint. The method is applicable to reletive young people who have localized and not generalized osteoarthritis, so to avoid surgery total knee replacement in this age. The method can be combined with cellular therapies such as injection into the joint PRP – autologous growth factors – or stem cells from the bone marrow of the patient himself. After surgery intrarticular injecting treatment with hyaluronic acid helps in faster relief of patient symptoms.