Background
Genu varus deformity secondary to tibia vara is one of the common deformities of the knee joint, and correction by using the Taylor spatial frame (TSF) is an effective method of treatment.
Aim of the study
This study evaluated the clinical, functional, and radiological outcomes after using the TSF for the correction of proximal tibial varus deformity.
Patients and methods
This prospective study was done on 14 patients, with eight males and six females, attending Saudi German Hospital in Saudi Arabia between October 2011 and January 2014, and the mean age was 18 years (range, 12–28 years) at the time of surgery. Patients included in the study have nontraumatic genu varus deformity secondary to tibia vara without degenerative changes in the knee. Follow-up evaluation of the results after 1 year of surgery was done using SF-36 scores, the American Academy of Orthopedic Surgeons Lower Limb Module scores, and an objective grading system modified by Tucker and colleagues.
Results
Patients had a preoperative mechanical axis deviation of 42 mm (range, 25–62 mm) medial to the midline, which was improved postoperative to an average of 4 mm (range, 2–8 mm) medial to the midline. The correction of medial proximal tibial angle was accurate, and the medial proximal tibial angle was improved from preoperative of 65° (range, 45–74°) to postoperative 88° (range, 86–92°). The posterior proximal tibial angle was corrected from preoperative of 72° (range, 66–74°) to postoperative 82° (range, 79–84°). Preoperative limb-length inequality was corrected in all patients, and the average was 0.5 cm (0–2 cm). There were no significant differences between preoperative and postoperative range of movements of both ankle and knee joints. The average postoperative range of motion of the knee joint was 0–130° and for the ankle joint was a 0–40°. Pin-tract infection was found in 42% of patients and treated by frequent dressing and oral antibiotics, and no patients had deep infection. Frame loosening was found in one (7%) patient and was treated by addition of wires. Follow-up evaluation after 1 year postoperatively was done by using SF-36 Health Survey scores, and it was improved in all categories, and according to the American Academy of Orthopedic Surgeons Lower Limb Module Patient Health Outcome score, it was increased from 64 to 92. In addition, according to the objective grading system of Tucker and colleagues, excellent results were achieved in 12 (86%) patients and good result in two (14%) patients.
Conclusion
Correction of genu varus deformity secondary to tibia vara through using TSF by proximal tibial osteotomy is an effective method to correct the deformity and restoring knee stability with early weight-bearing and high satisfactory results.