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Archives of Orthopaedic and Trauma Surgery
Published in: Archives of Orthopaedic and Trauma Surgery 3/2017

Open Access 01-03-2017 | Orthopaedic Surgery

Tibial condylar valgus osteotomy (TCVO) for osteoarthritis of the knee: 5-year clinical and radiological results

Authors: Ko Chiba, Akihiko Yonekura, Takashi Miyamoto, Makoto Osaki, Goji Chiba

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 3/2017

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Abstract

Purpose

Tibial condylar valgus osteotomy (TCVO) is a type of opening-wedge high tibial osteotomy for advanced medial knee osteoarthritis (OA) with subluxated lateral joint. We report the concept, the current surgical technique with a locking plate, and the short-term clinical and radiological results of this procedure.

Methods

11 knees with medial OA and a widened lateral joint were treated by TCVO (KL stage III: 6, IV: 5). In this procedure, by the L-shaped osteotomy from the medial side of the proximal tibia to the intercondylar eminence and the valgus correction, lateralization of the mechanical axis and reduction of the subluxated lateral joint are obtained with early postoperative weight-bearing. Before, 6 months, 1, and 5 years after the operation, a visual analog scale (VAS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC), alignment of the lower extremity, and congruency and stability of the femorotibial joint were investigated.

Results

The VAS improved from an average of 73 mm to 13 mm, and the total WOMAC score from 52 to 14 before to 5 years after the operation, respectively. The mechanical axis changed from 1 to 60%, and the FTA changed from 186° to 171°. The joint line convergence angle (JLCA) changed from 6° to 1°, and the angle difference of JLCA between varus and valgus stress improved from 8° to 4° after the procedure.

Conclusion

Improvements in pain and activities of daily living were observed by TCVO along with valgus correction of the lower extremity and stabilization of the femorotibial joint.
Literature
1.
Wright JM, Crockett HC, Slawski DP, Madsen MW, Windsor RE (2005) High tibial osteotomy. J Am Acad Orthop Surg 13(4):279–289CrossRefPubMed
2.
Akizuki S, Shibakawa A, Takizawa T, Yamazaki I, Horiuchi H (2008) The long-term outcome of high tibial osteotomy: a 10- to 20-year follow-up. J Bone Joint Surg Br 90(5):592–596CrossRefPubMed
3.
Takeuchi R, Umemoto Y, Aratake M, Bito H, Saito I, Kumagai K et al (2010) A mid term comparison of open wedge high tibial osteotomy vs unicompartmental knee arthroplasty for medial compartment osteoarthritis of the knee. J Orthop Surg Res 5(1):65CrossRefPubMedPubMedCentral
4.
Floerkemeier S, Staubli AE, Schroeter S, Goldhahn S, Lobenhoffer P (2013) Outcome after high tibial open-wedge osteotomy: a retrospective evaluation of 533 patients. Knee Surg Sports Traumatol Arthrosc 21(1):170–180CrossRefPubMed
5.
Bode G, von Heyden J, Pestka J, Schmal H, Salzmann G, Südkamp N et al (2015) Prospective 5-year survival rate data following open-wedge valgus high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 23(7):1949–1955CrossRefPubMed
6.
Chiba G (1992) New tibial osteotomy for severe osteoarthritis of the knee with teeter effect. J Jpn Orthop Assoc 66:798 (in Japanese)
7.
Kettelkamp DB, Leach RE, Nasca R (1975) Pitfalls of proximal tibial osteotomy. Clin Orthop Relat Res 106:232–241CrossRef
8.
Staubli AE, Simoni CD, Babst R, Lobenhoffer P (2003) TomoFix: a new LCP-concept for open wedge osteotomy of the medial proximal tibia—early results in 92 cases. Injury 34:55–62CrossRef
9.
Lobenhoffer P, Agneskirchner JD (2003) Improvements in surgical technique of valgus high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 11(3):132–138CrossRefPubMed
10.
11.
Fujisawa Y, Masuhara K, Shiomi S (1979) The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop Clin N Am 10(3):585–608
12.
Onodera J, Kondo E, Omizu N, Ueda D, Yagi T, Yasuda K (2014) Beta-tricalcium phosphate shows superior absorption rate and osteoconductivity compared to hydroxyapatite in open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 22(11):2763–2770CrossRefPubMed
13.
Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15(12):1833–1840PubMed
14.
Ogata K, Yoshii I, Kawamura H, Miura H, Arizono T, Sugioka Y (1991) Standing radiographs cannot determine the correction in high tibial osteotomy. J Bone Jt Surg Br 73(6):927–931
15.
Paley D, Herzenberg JE, Tetsworth K, McKie J, Bhave A (1994) Deformity planning for frontal and sagittal plane corrective osteotomies. Orthop Clin N Am 25(3):425–465
16.
Teramoto T, Chiba G, Fujita M (2000) Clinical results of tibial condylar valgus osteotomy (TCVO) for severe osteoarthritis of knee. Orthop Traumatol [Seikeigeka to saigaigeka] 49:37–41 (in Japanese) CrossRef
17.
Terauchi M, Shirakura K, Katayama M, Higuchi H, Takagishi K (1998) The influence of osteoporosis on varus osteoarthritis of the knee. J Bone Jt Surg Br 80(3):432–436CrossRef
18.
Takeuchi R, Ishikawa H, Kumagai K, Yamaguchi Y, Chiba N, Akamatsu Y et al (2012) Fractures around the lateral cortical hinge after a medial opening-wedge high tibial osteotomy: a new classification of lateral hinge fracture. Arthroscopy 28(1):85–94CrossRefPubMed
19.
van Houten AH, Heesterbeek PJC, van Heerwaarden RJ, van Tienen TG, Wymenga AB (2014) Medial open wedge high tibial osteotomy: can delayed or nonunion be predicted? Clin Orthop Relat Res 472(4):1217–1223CrossRefPubMed
Metadata
Title
Tibial condylar valgus osteotomy (TCVO) for osteoarthritis of the knee: 5-year clinical and radiological results
Authors
Ko Chiba
Akihiko Yonekura
Takashi Miyamoto
Makoto Osaki
Goji Chiba
Publication date
01-03-2017
Publisher
Springer Berlin Heidelberg
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 3/2017
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-016-2609-3

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