Application of external osteosynthesis in correction of varus deformation of lower extremities in patients with gonarthrosis

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Abstract

Background. Arthrosis of the knee joint is one of the most common diseases in elderly patients with the varus deformity. One of the treatment methods is corrective osteotomy. Aims: optimization of the diagnosis of deformities in patients with gonarthrosis, improvement of the technique of operation and postoperative control of the main reference lines and angles, assessment of the correction results, analysis of complications. Methods. A retrospective clinical study was conducted. 39 patients were observed, in whom 78 operations were performed on both legs simultaneously. In all the cases, tibia osteotomies and osteosynthesis with the Ilizarov apparatus were used. All the patients underwent an X-ray study of the legs along the entire length with the identification of the main reference lines and angles. Results. In all the cases, it was possible to normalize the position of the mechanical axis and the angle of orientation of the knee joint. After the surgery, the wounds were not sutured to prevent compartment syndrome. The correction was performed in a single-stage manner in elderly patients, gradually in young patients. The period of fixation with the Ilizarov apparatus was 16.6 ± 3.1 weeks. Conclusions. The Ilizarov method has significant advantages: low invasiveness, stable fixation, absence of foreign bodies to the end of treatment. This allows us to recommend it for a wider use in patients with gonarthrosis and varus deformity.

About the authors

Aleksander A. Artemiev

Academy of Postgraduate Education under the FSBU “Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies FMBA of Russia”

Email: alex_artemiev@mail.ru
SPIN-code: 3124-2701

MD, PhD, Professor

Russian Federation, Moscow

Alexander A. Akhpashev

Academy of Postgraduate Education under the FSBU “Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies FMBA of Russia”

Email: akhpashev@gmail.com
ORCID iD: 0000-0002-0977-805X
SPIN-code: 9965-1828

MD, PhD

Russian Federation, Moscow

Medetbek D. Abakirov

Academy of Postgraduate Education under the FSBU “Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies FMBA of Russia”

Email: Abakirovmedetbek@mail.ru

MD, PhD, Professor

Russian Federation, Moscow

Andrej N. Reshetnikov

Saratov State Medical University named after V.I. Razumovsky

Email: anreshetnikov@gmail.com

MD, PhD, Professor

Russian Federation, Saratov

Aleksander A. Shipulin

Peoples Friendship University of Russia, Medical Institute

Email: mp-747@yandex.ru

MD, aspirant

Russian Federation, Moscow

Gevorg G. Gululyan

Peoples Friendship University of Russia, Medical Institute

Email: gululov@yandex.ru

MD, aspirant

Russian Federation, Moscow

Ali M. Kashoob

Peoples Friendship University of Russia, Medical Institute

Author for correspondence.
Email: Dr.ali.kashoob@gmail.com
ORCID iD: 0000-0002-4999-585X

MD, aspirant

Russian Federation, Moscow

Yurij S. Solovyov

Peoples Friendship University of Russia, Medical Institute

Email: iurij.soloviov@yandex.ru

MD, aspirant

Russian Federation, Moscow

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Supplementary files

Supplementary Files
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2. Fig. 1. Radiography of the lower extremities along the entire length in frontal projection

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3. Fig. 2. Radiography of the lower extremities along the entire length in lateral projection

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4. Fig. 3. A 57-year-old female patient with bilateral varus deformity and stage II gonarthrosis

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5. Fig. 4. Radiographs of the same patient with bilateral varus deformity and stage II gonarthrosis: precise symmetrical correction of the shape of the lower extremities with movement of the mechanical axis to the normal (neutral) position

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Copyright (c) 2020 Artemiev A.A., Akhpashev A.A., Abakirov M.D., Reshetnikov A.N., Shipulin A.A., Gululyan G.G., Kashoob A.M., Solovyov Y.S.

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This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

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