Abstract: Background: Knee osteoarthritis (OA) may cripple an individual due to pain and/or deformity, resulting in disability and diminished quality of life. The goal in these patients is to relieve pain, provide motion, maintain stability and correct deformity.
Surgical treatment options are required in arthritic knees with radiographic evidence of joint damage and not responding to conservative treatment. Total knee Arthroplasty (TKA) is usually preferred for severe arthritic knees in this modern era of joint replacement. However, it is expensive and has its own set of complications and survival rates depending on surgical technique, implant design and comorbid conditions. Hence, in developing countries like India where majority patients are from poor socioeconomic status, other treatment options deserve consideration especially for early mild to moderate Unicompartmental OA. Proximal tibial osteotomy (PTO) has been a good alternative surgical treatment in such patients.
Aim: To evaluate the results of PTO followed by above knee plaster of Paris (POP) cast application for medial compartment knee OA.
Material and Methods: A prospective study was done on 11 knees in 11 patients (4 males, 7 females) who underwent proximal tibial inverted ‘V’ osteotomy followed by above knee POP cast application for the treatment of medial compartment knee OA. Grading of OA was done according to Ahlback’s classification. All patients were followed up for 1 year and assessed for progress of union, pain relief, range of motion (ROM) and deformity correction. Evaluation was done as per criteria by Japanese Orthopaedics Association Score for knee arthritis (1992).
Observations and Results: The mean age of patients was 61.02 years. The preoperative flexion and varus deformities improved in majority after the PTO. Preoperatively all patients had poor score. Postoperatively at the end of 1 year, 90.91% patients had fair or good results. Superficial infection occurred in one patient which healed with dressings and antibiotics. One patient developed compartment syndrome for which fasciotomy had to be done.
Conclusion: PTO followed by above knee POP cast application is a satisfactory and cost- effective alternative to knee replacement surgery for isolated medial compartment knee OA in developing countries like India.
