Efficacy of proximal tibial focal-dome type osteotomy on medial joint laxity
Taner Güneş1, Cengiz Şen1, Bora Bostan1, Mehmet Erdem1, Ahmet Kalaycıoğlu2
1Ortopedi ve Travmatoloji Anabilim Dalı, Gaziosmanpaşa Üniversitesi Tıp Fakültesi Tokat, Türkiye
2Anatomi Anabilim Dalı, Karadeniz Teknik Üniversitesi Tıp Fakültesi Trabzon, Türkiye
Keywords: Knee, Osteoarthritis, Medial collateral ligament, Osteotomy.
Objectives: Medial laxity is an important problem in medial-compartment gonarthrosis and it can cause progression of degeneration. Therefore, during high tibial osteotomy, in addition to the correction of mechanical axis, managing of medial laxity is very important. In this study, the effect of opening focal-dome osteotomy on the medial laxity was investigated. Materials and methods: Four knees of two cadavers (74-year-old male and 52-yearold female) were used in this study. To create medial laxity in the knee, while total medial menisectomy was performed in two knees in the male cadaver, and 5 mm of resection of both joint surfaces of the medial femoral condyle and medial tibial plateau in addition to the menisectomy was performed in two knees of female cadaver. Then, opening focal-dome type osteotomy was initiated passing under the tuberositas tibia and extending to the proximal point of insertion of superficial medial collateral ligament, and 15° valgus angulation was applied to the osteotomy line by motor unit of the circular fixator. Varus and valgus angulation were applied to the knee joint, and medial opening was measured before and after the osteotomy.
Results: After osteotomy, the average decrease of medial opening was 70%.
Conclusion: Opening focal-dome osteotomy decreases medial laxity effectively by tightening the superficial medial collateral ligament.