Comparison of the complication rate of knee osteotomies in two levels (double osteotomy) and one level in patients with genu varum

Abstract

Double stotomy was first performed in 1969 by Benjamin on osteoarthritis patients who did not respond to conservative treatment despite one year; Since then, limited studies have been performed as a case report, but so far no comprehensive study on valgus stotomy around the knee has been performed at two levels. The concern with this type of stotomy is that due to the two large operations around the knee, the possibility of complications such as movement limitation and nonunion increases. Therefore, in this study, in addition to reviewing the results of double stotomy, we compared its complications with stotomy at the same level. Materials and Methods: In this Prospective cohort study that was performed during 2019 and 2020, patients whose genovarum is 10 degrees or more, which is measured based on graph and angle and the location of the osteotomy is determined, the rate of degenerative changes is included. The medial, lateral, and patellofemoral cartilages of the knee were determined according to the Ahlbach classification and, if contraindicated, underwent simultaneous osteotomy. The type of ostomy was determined based on LDFA and MTPA angles and patients were divided into three groups: tibial ostomy, femoral ostomy and double ostomy. Patients were visited in the first and second weeks for wound healing complications and then every month at the same time as the clinical examination, the osteoctomy site was evaluated with a graph. Complications related to surgery were recorded during this period as well as the time of the union. At one year, the range of motion of the knee was measured and the patient's performance was assessed with IKDC and KOOS questionnaires Results: The studies performed after the intervention showed that the amount of varus angle, Flex, Ext and also ROM between different groups were not statistically significant. On the other hand, the results within the group indicated that in all the mentioned variables in all three groups participating in the study, the results were accompanied by improvement; The results show that the rate of improvement in the mentioned variables was associated with the most improvement in the double osteotomy group and with the least improvement in the tibia osteotomy group; In the evaluation of functional questionnaires, the rate of improvement of the results was the best improvement in the double osteotomy group and the least improvement in the tibial osteotomy group