Keywords
Ilizarov technique
Knee osteoarthritis
Varus deformity
Submitted : 2023-08-27
Accepted : 2023-09-11
Published : 2023-09-26
Abstract
This paper aims to analyze the clinical efficacy of minimally invasive osteotomy combined with Ilizarov technique in the treatment of knee osteoarthritis with varus deformity. 80 patients with knee osteoarthritis and varus deformity who were treated in our hospital from January 2022 to May 2023 were selected, all of whom were affected by one knee. They were randomly divided into groups, including the study group and the control group, each with 40 patients. Patients in the control group were treated with fibula-tibial osteotomy and internal fixation, and patients in the study group were treated with minimally invasive osteotomy combined with Ilizarov technique. The operation time of the patients in the study group was significantly longer than that of the control group (P < 0.05). The intraoperative blood loss of the patients in the study group was significantly more than that of the control group (P < 0.05). The hospitalization expenses of the patients in the study group were significantly more than those of the control group (P < 0.05). The postoperative femorotibial angle and mechanical axis offset distance in the study group were significantly smaller than those in the control group (P < 0.05). The postoperative New York Hospital for Special Surgery (HSS) scores of the study group were significantly higher than those of the control group (P < 0.05). The postoperative visual analogue scale (VAS) score of the study group was significantly lower than that of the control group (P < 0.05). The range of motion of the knee joint in the study group was significantly greater than that in the control group (P < 0.05). The incidence of tendon injury, infection, and nerve injury in the study group (2.50%) was significantly lower than that in the control group (30.00%) (P < 0.05). Minimally invasive osteotomy combined with Ilizarov technique can be applied in the treatment of knee osteoarthritis with varus deformity, although the operation time is longer, with more intraoperative blood loss and higher treatment cost, but it has no effect on the femorotibial angle and mechanical axis deviation of the patient. It can significantly improve the movement distance, knee joint function, and knee joint range of motion, and significantly reduce the postoperative pain of patients, reduce the incidence of complications, and thus has high clinical application value.
References
Zheng H, Ning R, Yin H, et al., 2022, Application of Selective Pie-Crusting Technique in Primary Total Knee Arthroplasty for Severe Genu Varus. Chinese Journal of Bone and Joint Injuries, 37(06): 622–625.
Hu W, 2022, Clinical Effect of Artificial Total Knee Replacement in the Treatment of Knee Osteoarthritis with Severe Genu Varus Deformity. Clinical Medicine Research and Practice, 7(03): 78–80.
Mu W, Xu B, Guo W, et al., 2022, Early Curative Effect of Total Knee Arthroplasty Assisted by MAKO Robot in the Treatment of Knee Osteoarthritis with Severe Varus Deformity. Chinese Journal of Bone and Joint Surgery, 15(08): 612–618.
Li Q, Zhai X, Qin L, et al., 2019, Observation on the Short-Term Curative Effect of High Tibial Osteotomy
Combined with Arthroscopic Debridement in the Treatment of Medial Unicompartmental Osteoarthritis of the Knee Joint. Journal of Clinical Medicine Literature, 6(11): 17–19 + 22.
Dong Y, Song Q, Xu X, et al., 2022, Clinical Research on Pie-Crusting Technique in the Treatment of Varus Deformity of Knee Osteoarthritis in Total Knee Arthroplasty. Chinese Medicine Herald, 19(06): 85–88.
Zhang G, Zhang G, 2022, Clinical Comparative Study of Knee Arthroscopic Debridement Combined with Upper Fibula Osteotomy and Upper Fibula Osteotomy for Varus Knee Osteoarthritis. Henan Surgical Journal, 28(01): 140–142.
Hu H, Gao Y, Liu Z, et al., 2019, Clinical Research on the Relationship Between Knee Varus Deformity and Tibial Rotation Angle in Patients with Knee Osteoarthritis. Chinese Journal of Geriatric Orthopedics and Rehabilitation, 5(02): 99–104.
Diao N, Dai Y, Yu F, et al., 2023, The Application of Tibial Plateau Reduction Technology Combined with Limited Medial Soft Tissue Release in Total Knee Arthroplasty. Chinese Journal of Bone and Joint Surgery, 16(03): 226–231.
Liu N, Wei H, Tian X, et al., 2023, Clinical Observation of Arthroscopic Debridement Combined with High Tibial Osteotomy in the Treatment of Early Varus Knee Osteoarthritis. Clinical Misdiagnosis and Mistreatment, 36(02):
85–89.
Li G, Zhao H, Zhang J, et al., 2023, Efficacy of Medial Open Wedge High Tibial Osteotomy in the Treatment of Knee Varus Deformity and its Influence on Postoperative Lower Limb Alignment and Traumatic Stress. Advances in Modern Biomedicine, 23(02): 345–349.
Zhou J, Ge Z, He L, et al., 2022, Comparison of the Effects of Different Surgical Methods in Treating Patients with Medial Compartment Cartilage Injury of the Knee Joint with Genu Varus and Their Influence on the Level of Force Line of the Lower Limbs. Medical Theory and Practice, 35(24): 4204–4206.
Hu Z, Xia L, Hao F, et al., 2022, Comparison of the Application Effect of Gap Balance Technique and Measuring Osteotomy Technique in Total Knee Arthroplasty in Patients with Varus Knee Osteoarthritis. Journal of Xinxiang Medical College, 39(12): 1145–1149 + 1154.
Jin P, 2021, Effect Analysis of Arthroscopy Combined with Fibula Osteotomy and Microfracture Technique in the Treatment of Varus Knee Osteoarthritis. China Health and Nutrition, 31(8): 223.
Xie W, Shang H, Sun W, 2021, Analysis of the Effect of High Tibial Osteotomy in the Treatment of Knee Osteoarthritis with Genu Varus. Chinese Journal of Disability Medicine, 29(8): 31–32.
Pan H, Liu G, Li L, et al., 2022, Effect of High Tibial Biplane Ascending Osteotomy and Descending Osteotomy on Varus Knee Osteoarthritis and Gait Analysis. Bio-Orthopedic Materials and Clinical Research, 19(1): 25–30.
Zeng L, Liao H, Yang F, et al., 2022, Effect of Improved llizarov Minimally Invasive Proximal Tibial Osteotomy Plate Internal Fixation on Knee Joint Function in Patients with Knee Osteoarthritis Complicated with Genu Varus. Clinical and Experimental Journal of Medicine, 21(11): 1174–1178.
Xia K, Ruan W, Liu D, et al., 2022, Arthroscopy Combined with Open Wedge High Tibial Osteotomy for Varus Knee Osteoarthritis. Journal of Practical Orthopedics, 28(8): 750–754.
Wang L, Yang P, Wang K, 2020, Effect of Ilizarov Surgery Combined with Minimally Invasive Osteotomy on Knee Joint Function in Patients with Knee Osteoarthritis Complicated with Genu Varus. Shaanxi Medical Journal, 49(1): 37 –39.
Ma K, Gou L, Guo H, et al., 2020, Comparison of the Curative Effects of Three Minimally Invasive Procedures in the Treatment of Medial Knee Osteoarthritis. Chinese Journal of Orthopedics and Traumatology, 28(6): 10–15.
Zhao X, Xu B, Xiao T, et al., 2021, The Effect of Proximal Fibular Osteotomy on Knee Joint Mobility and Complications in Patients with Varus Knee Osteoarthritis. Practical Hospital Clinical Journal, 18(2): 22–26.