Combination of external fixation using digital six-axis fixator and internal fixation to treat severe complex knee deformity

Journal of Orthopaedic Surgery and Research

Research Article

Jun Li¹  Shu-guang Liu¹  Hui Li¹  Michael Opoku²  Yu-sheng Li²  Deng-jie Yu²  Feng Qiao³  Bao-gang Zhang³ 

[1] Department of Joint Surgery, Honghui Hospital, Xi’an Jiao Tong University, Xi’an, Shaan Xi, China;Department of Orthopedics, Xiangya Hospital Central South University, No. 87 Xiangya Road, Kaifu District, 410008, Changsha City, Hunan, China;Orthopedic Department of Integrated Traditional Chinese and Western Medicine, Honghui Hospital, Xi’an Jiao Tong University, No. 555, Youyi East Road, Nanshaomen, Beilin District, 710054, Xi’an City, Shaan Xi, China;

关键词: Knee;    Osteotomy;    Valgus;    Varus;    Q spatial fixator (QSF);   

DOI  :  10.1186/s13018-023-03530-0

 received in 2022-02-08, accepted in 2023-01-11,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundSevere knee valgus/varus or complex multiplanar deformities are common in clinic. If not corrected in time, cartilage wear will be aggravated and initiate the osteoarthritis due to lower limb malalignment. Internal fixation is unable to correct severe complex deformities, especially when combined with lower limb discrepancy (LLD). Based on the self-designed digital six-axis external fixator Q spatial fixator (QSF), which can correct complex multiplanar deformities without changing structures, accuracy of correction can be improved significantly.MethodsThis retrospective study included 24 patients who suffered from complex knee deformity with LLD treated by QSF and internal fixation at our institution from January 2018 to February 2021. All patients had a closing wedge distal femoral osteotomy with internal fixation for immediate correction and high tibia osteotomy with QSF fixation for postoperative progressive correction. Data of correction prescriptions were computed by software from postoperative CT scans.ResultsMean discrepancy length of operative side was 2.39 ± 1.04 cm (range 0.9–4.4 cm) preoperatively. The mean difference of lower limb was 0.32 ± 0.13 cm (range 0.11–0.58 cm) postoperatively. The length of limb correction had significant difference (p < 0.05). The mean MAD and HKA decreased significantly (p < 0.05), and the mean MPTA and LDFA increased significantly (p < 0.05). There were significant increase (p < 0.05) in the AKSS-O, AKSS-F and Tegner Activity Score. The lower limb alignment was corrected (p < 0.05). The mean time of removing external fixator was 112.8 ± 17.9 days (range 83–147 days).ConclusionsComplex knee deformity with LLD can be treated by six-axis external fixator with internal fixation without total knee arthroplasty. Lower limb malalignment and discrepancy can be corrected precisely and effectively by this approach.

【 授权许可】

CC BY   
© The Author(s) 2023

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