Reconstructive operations in medical treatment of patients with osteoarthrosis of knee joint.

Reconstructive operations in medical treatment of patients with osteoarthrosis of knee joint.

Gayko G.V., Pidgayetsky V.M., Sulima O.M., Osadchuk T.I.

Institute of orthopaedy and travmatology of AMC of Ukraine, Kiev, Ukraine

In Ukraine the prevalence of osteoarthrosis is almost 500 persons per a 100 thousands of population. Frequency of osteoarthrosis of knee joint arrives at 24 – 68% from all degenerative-dyistrophic defeats of joints.

               Determination of the differentiated approach to the choice of operative interferences at patients on the late stages of osteoarthrosis of knee joint was the purpose of the given research.

 Our work is based on experience of surgical medical treatment in 223 patients with osteoarthrosis of knee-joints of the III - IV stage to patients were executed the following operative interferences: supratubercular corriggative osteotomy of tibia, supracondylar corriggative osteotomy of femur and total knee arthroplasty.

At varus deformations of knee-joint, which are conditioned by violation of axis of tibia, that roentgenologic showed up reduction of base-tibial corner, when amplitude of motions in a knee-joint was 80° is not less, with the deficit of unbending no more 10°, we executed supratubercular corriggative osteotomy of tibia with the use of autotransplantes, the proper sizes, from the wing of ilium with the use of osteosintesis by the metallic plate of developed in a clinic. After the given method 168 patients are operated.

At deformations of region of knee-joint of conditioned by violation of axis of thigh-bone, that roentgenologic showed up the change of base-femoral corner, at the satisfactory volume of motions in a knee-joint, we executed supracondylar corriggative osteotomy of femur with the resection of wedge and the L-shape fixing, metallic 95° plate. After the given method 35 patients with valgus deformation of knee-joints are operated.                                                                                   At patients with sharp limitation of volume of motions in a knee-joint, by the presence of bend contractioni more 10°,  bending no more 100°, roentgenologic considerable destructive changes in a joint we executed total knee replacement, 28 knee-joints in 20 patients are operated.

For results evaluation we developed a pointed system which included patient’s feelings, pain, lameness, movement rate, side instability of the knee joint, deformity of the knee in frontal plane.

We received good and excellent results in 75% of cases, poor results in 22,5% and fair results in 2,5%.

For results evaluation we developed a pointed system which included patient’s feelings, pain, lameness, movement rate, side instability of the knee joint, deformity of the knee in frontal plane.

We received good and excellent results in 75% of cases, poor results in 22,5% and fair results in 2,5%.