Introduction: Osteoarthritis of knee is more common among all types of arthritic conditions. High tibial osteotomy is an accepted surgical technique for treatment of medial compartment arthrosis of knee in younger patients. Selection of the appropriate patients, extensive pre-operative planning and accurate surgical technique are essential for successful outcome. The methods of high tibial osteotomy include open wedge osteotomy and closed wedge osteotomy, the later procedure being more popular. Aims and Objectives: To assess the functional outcome among patients undergoing high tibial osteotomy. Methodology: A hospital based prospective interventional study was done on 30 patients of osteoarthritis with varus deformity. For all the 30 patients after a proper preoperative assessment the surgical intervention in the form of high tibial osteotomy was done and the outcome was evaluated using knee society scoring system. Results: Among the study population 73.3% of the patients had grade III type of osteoarthritis and only 26.6% had grade IV type of osteoarthritis based on Kellgren and Lawrence type of classification. The mean knee score and the mean functional score of the patients before surgery were 54.6 and 53.9 respectively and post operatively at the end of 12 months the knee score and functional score was 83.1 and 82 respectively. A statistically significant improvement was seen in both the knee society score and the functional score. Conclusion:The main improvements seen in this study was the increase in the knee score and functional score after high tibial osteotomy for the patients of osteoarthritis with varus deformity. Appropriate patient selection, proper osteotomy types and precise surgical techniques are essential for the success of high tibial osteotomy.
Background: Management of nonunion with bone loss of long bones is a matter of debate. The treatment options range from external fixator, Masquelet technique, nailing, ring fixator, bone grafting with or without plastic reconstruction. All the procedures have their own set of complications like acute docking problems, shortening, difficulty in soft tissue management, chronic infection, increased morbidity, multiple surgeries, longer hospital stay, malunion, nonunion and higher patient dissatisfaction. We evaluated the outcome of the limb reconstruction system (LRS) in the treatment of infected non union and bone loss of long bones as a definitive mode of treatment to achieve union as well as eradication of simultaneously. Aim: The aim of the study is to analyze the outcome of treatment of Infected and Gap Nonunion of long bones by using Limb Reconstruction System (The dynamic external fixation system and Rail fixation system) and reveal its real usefulness. Method and Materials: In this study, we included 21cases of infected non-union with age range from 16 yrs to 65 yrs (with a mean age of 37.5 yrs) of which 19 males (90.47%) and 2 females (9.53%) using AO classification for infected nonunion categorized them into Infected non-draining nonunion (Active/Quiescent) and Infected draining nonunion treated them with limb reconstruction system (LRS). Results: Results were analyzed as per the ASAMI criteria (Association for the Study and Application of Methods of Illizarov) and complications as per Paley's classification. Of the 21patients union achieved in 18 patients (85.7%). Union time ranged from 4 to 9 months (mean 5.9months). Sinus tract got cleared in all cases except 3 where the sinus tracts were multiple and there was no progression towards union in those three cases. Out of 21 cases 11 cases had pin tract infection (52.3%) which was most common problem in this study. Conclusion:The limb reconstruction system is uniplanar and less bulky. Use of limb reconstruction system is convenient and effective method for the treatment of infected and gap nonunion of long bones. This can also be used to correct the limb length discrepancies simultaneously.
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