MANAGEMENT OF KNEE DEFORMITIES USING DOUBLE LEVEL OSTEOTOMY TECHNIQUE

Mahmoud Reza Fayyaz, MD; Amir Farahanchi Baradaran, MD; Fateme Mirzaee, MSc; Azizollah Shirvani, MD; Omid Sheikhhasan, MD; and Hamidreza Aslani, MD*

ABSTRACT

Introduction: Double level osteotomy was first introduced by Benjamin in 1969 for patients with disabling knee pain due to osteoarthritis or rheumatoid arthritis. This procedure is now being used to correct the deformity, realign knee joint obliquity and weight-bearing lines, and pain reduction. The purpose of this report is to express clinical experience with the use of this surgical technique and to describe the long-term follow-up of the patients who were operated on. Methods: During a 4-year period, 9 patients (12 knees) with the mean age of 43.5 years underwent Surgery due to genu varum. Lysholm score and KOOS score were used for functional assessment, pre and post-operatively. The mechanical tiboifemoral angle was evaluated with anteroposterior radiographs taken while the patients were standing on both legs with full extension of the knees. In the surgical procedure, we first started from closed- wedge biplanar osteotomy of femur, and following that according to X-ray determination we performed tibial open-wedge biplanar osteotomy. Results: All patients returned with good and acceptable performance. The mean KOOS score and Lysholm score were 91.4 and 85.6 points post-operatively. Most patients were satisfied with the results of their surgery and all the angles measured on X-rays had been corrected. Conclusion: In general, we can conclude that the double level osteotomy technique is an acceptable and reliable method. Although this technique is delicate and has some difficulties, finally there are good and satisfying results for patients. Our experience in using this surgical technique showed that this method could be a valid treatment option for the treatment of knee deformity.

Keywords: Double level osteotomy, knee deformities, genu varum.