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Open wedge osteotomy and callus distraction by means of the external fixator in distal femur and proximal tibia in knee arthrosis with valgus and varus deformity

Milenković Saša (Ortopedsko-traumatološka klinika, Niš)
Mitković Milorad B. (Ortopedsko-traumatološka klinika, Niš)
Radenković Mile (Ortopedsko-traumatološka klinika, Niš)
Stanojković Miodrag (Ortopedsko-traumatološka klinika, Niš)
Micić Ivan (Ortopedsko-traumatološka klinika, Niš)
Karalejić Saša (Ortopedsko-traumatološka klinika, Niš)

Various methods can be applied for treatment of knee deformity. One of them is open wedge osteotomy and callus distraction by means of the external fixator. This paper presents the results of treatment of 16 patients with knee arthrosis associated with varus and valgus deformities (10 varus and 6 valgus deformities). Open wedge osteotomy of the varus deformity was performed in the proximal tibia, and in case of the valgus deformity in the distal part of the femur. The patients who were operated on had a knee varus larger than 10 degrees and a knee valgus larger than 12 degrees. Prior to open wedge osteotomy and application of the external fixator, knee arthroscopy was performed (meniscectomy, cartilage drilling and shaving, debridement, the extraction of loose bodies). After one-year follow-up, the final outcome of the treatment was positive in all patients. The treatment alleviated the pain in these patients. The method is minimally invasive and relatively easily applied. Mitkovic's external fixator type M20-CD-V allows for continuous callus distraction with simultaneous correction of the varus or valgus knee deformity.

Keywords: open wedge osteotomy, callus distraction, external fixator, knee arthrosis, valgus and varus deformity