The role of microfractures with tibial osteotomy in the treatment of knee osteoarthritis with a varus deformity

Detalhes bibliográficos
Autor(a) principal: Souza,Leonardo Antunes Bellot de
Data de Publicação: 2018
Outros Autores: Rocha,Vinícius Magno da, Ramos,Max Rogerio Freitas
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Revista Brasileira de Ortopedia (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162018000600754
Resumo: ABSTRACT Objective: To evaluate the microfracture intervention with tibial valgus osteotomy associated in the treatment of varus gonarthrosis. Methods: From November 2005 to May 2013, 129 patients with medial gonarthrosis, varus deformity (8°-12°), and range of movement greater than 90° were evaluated. Patients with advanced gonarthrosis (Alhbäck 3, 4, and 5), Outerbridge lesion inferior to IV, previous knee surgery, body mass index greater than 35 kg/m2, and/or cruciate ligament injuries were not included. All patients were treated with videoarthroscopy followed by tibial valgus osteotomy. In the group osteotomy associated with microfracture (n = 56, mean age = 39.3), tibial valgus osteotomy and microfracture techniques to address chondral defects were used. In the isolated osteotomy group (n = 73, mean age = 41.4), only this procedure was performed. Post-surgical follow-up was 24 months, with four evaluations in the first 6 months, proceeding to biannual twice-a-year evaluation in the subsequent period. The Lysholm scale was used for functional monitoring. Results: There was a significant improvement in the pain, limping, and squatting domains of the Lysholm scale but only in the isolated osteotomy group. A greater variance of results was observed in the osteotomy group associated to microfracture, in addition to an increased risk of functional deterioration (OR = 8.64). Conclusion: The association of microfractures and tibial valgus osteotomy was correlated to lower functional outcomes than tibial valgus osteotomy alone, and may be related to the risk of worsening in the first two postoperative years.
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spelling The role of microfractures with tibial osteotomy in the treatment of knee osteoarthritis with a varus deformityKnee osteoarthritisGenu varumOsteotomyArthroscopyLysholm knee scoreABSTRACT Objective: To evaluate the microfracture intervention with tibial valgus osteotomy associated in the treatment of varus gonarthrosis. Methods: From November 2005 to May 2013, 129 patients with medial gonarthrosis, varus deformity (8°-12°), and range of movement greater than 90° were evaluated. Patients with advanced gonarthrosis (Alhbäck 3, 4, and 5), Outerbridge lesion inferior to IV, previous knee surgery, body mass index greater than 35 kg/m2, and/or cruciate ligament injuries were not included. All patients were treated with videoarthroscopy followed by tibial valgus osteotomy. In the group osteotomy associated with microfracture (n = 56, mean age = 39.3), tibial valgus osteotomy and microfracture techniques to address chondral defects were used. In the isolated osteotomy group (n = 73, mean age = 41.4), only this procedure was performed. Post-surgical follow-up was 24 months, with four evaluations in the first 6 months, proceeding to biannual twice-a-year evaluation in the subsequent period. The Lysholm scale was used for functional monitoring. Results: There was a significant improvement in the pain, limping, and squatting domains of the Lysholm scale but only in the isolated osteotomy group. A greater variance of results was observed in the osteotomy group associated to microfracture, in addition to an increased risk of functional deterioration (OR = 8.64). Conclusion: The association of microfractures and tibial valgus osteotomy was correlated to lower functional outcomes than tibial valgus osteotomy alone, and may be related to the risk of worsening in the first two postoperative years.Sociedade Brasileira de Ortopedia e Traumatologia2018-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162018000600754Revista Brasileira de Ortopedia v.53 n.6 2018reponame:Revista Brasileira de Ortopedia (Online)instname:Sociedade Brasileira de Ortopedia e Traumatologia (SBOT)instacron:SBOT10.1016/j.rboe.2017.08.023info:eu-repo/semantics/openAccessSouza,Leonardo Antunes Bellot deRocha,Vinícius Magno daRamos,Max Rogerio Freitaseng2018-11-29T00:00:00Zoai:scielo:S0102-36162018000600754Revistahttp://www.rbo.org.br/https://old.scielo.br/oai/scielo-oai.php||rbo@sbot.org.br1982-43780102-3616opendoar:2018-11-29T00:00Revista Brasileira de Ortopedia (Online) - Sociedade Brasileira de Ortopedia e Traumatologia (SBOT)false
dc.title.none.fl_str_mv The role of microfractures with tibial osteotomy in the treatment of knee osteoarthritis with a varus deformity
title The role of microfractures with tibial osteotomy in the treatment of knee osteoarthritis with a varus deformity
spellingShingle The role of microfractures with tibial osteotomy in the treatment of knee osteoarthritis with a varus deformity
Souza,Leonardo Antunes Bellot de
Knee osteoarthritis
Genu varum
Osteotomy
Arthroscopy
Lysholm knee score
title_short The role of microfractures with tibial osteotomy in the treatment of knee osteoarthritis with a varus deformity
title_full The role of microfractures with tibial osteotomy in the treatment of knee osteoarthritis with a varus deformity
title_fullStr The role of microfractures with tibial osteotomy in the treatment of knee osteoarthritis with a varus deformity
title_full_unstemmed The role of microfractures with tibial osteotomy in the treatment of knee osteoarthritis with a varus deformity
title_sort The role of microfractures with tibial osteotomy in the treatment of knee osteoarthritis with a varus deformity
author Souza,Leonardo Antunes Bellot de
author_facet Souza,Leonardo Antunes Bellot de
Rocha,Vinícius Magno da
Ramos,Max Rogerio Freitas
author_role author
author2 Rocha,Vinícius Magno da
Ramos,Max Rogerio Freitas
author2_role author
author
dc.contributor.author.fl_str_mv Souza,Leonardo Antunes Bellot de
Rocha,Vinícius Magno da
Ramos,Max Rogerio Freitas
dc.subject.por.fl_str_mv Knee osteoarthritis
Genu varum
Osteotomy
Arthroscopy
Lysholm knee score
topic Knee osteoarthritis
Genu varum
Osteotomy
Arthroscopy
Lysholm knee score
description ABSTRACT Objective: To evaluate the microfracture intervention with tibial valgus osteotomy associated in the treatment of varus gonarthrosis. Methods: From November 2005 to May 2013, 129 patients with medial gonarthrosis, varus deformity (8°-12°), and range of movement greater than 90° were evaluated. Patients with advanced gonarthrosis (Alhbäck 3, 4, and 5), Outerbridge lesion inferior to IV, previous knee surgery, body mass index greater than 35 kg/m2, and/or cruciate ligament injuries were not included. All patients were treated with videoarthroscopy followed by tibial valgus osteotomy. In the group osteotomy associated with microfracture (n = 56, mean age = 39.3), tibial valgus osteotomy and microfracture techniques to address chondral defects were used. In the isolated osteotomy group (n = 73, mean age = 41.4), only this procedure was performed. Post-surgical follow-up was 24 months, with four evaluations in the first 6 months, proceeding to biannual twice-a-year evaluation in the subsequent period. The Lysholm scale was used for functional monitoring. Results: There was a significant improvement in the pain, limping, and squatting domains of the Lysholm scale but only in the isolated osteotomy group. A greater variance of results was observed in the osteotomy group associated to microfracture, in addition to an increased risk of functional deterioration (OR = 8.64). Conclusion: The association of microfractures and tibial valgus osteotomy was correlated to lower functional outcomes than tibial valgus osteotomy alone, and may be related to the risk of worsening in the first two postoperative years.
publishDate 2018
dc.date.none.fl_str_mv 2018-12-01
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dc.language.iso.fl_str_mv eng
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dc.relation.none.fl_str_mv 10.1016/j.rboe.2017.08.023
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dc.publisher.none.fl_str_mv Sociedade Brasileira de Ortopedia e Traumatologia
publisher.none.fl_str_mv Sociedade Brasileira de Ortopedia e Traumatologia
dc.source.none.fl_str_mv Revista Brasileira de Ortopedia v.53 n.6 2018
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