Abstract            Volume:4  Issue-8  Year-2016         Original Research Articles

Online ISSN : 2347 - 3215 Issues : 12 per year Publisher : Excellent Publishers Email : editorijcret@gmail.com

Pain in the knee joint is one of the most complaints found among the patient attending outdoor. Its existence dates since the adoption of erect posture by mankind. Arthritis may cause mild to moderate pain while to pain at rest joint stiffness varus or valgus deformity. These may withheld a person from his job by preventing him from sitting cross-legged, squat or climb the stairs or walk distances etc. Role of high tibial osteotomy has been studied for prompt relief of symptoms and thus make the patient able to lead a longer independent life. 400 cases were operated during a time period of 11 years from 2005 to 2016. Majority of them were sedentary workers. Majority of the patients have duration of complaints between 1-2 years. The Pain was mostly located on the medial side & the pre operative feeling of instability was absent in majority of cases. The Pre operative range of movement was between 90-120 degrees in 68% of cases. Apart from progressive varus deformity in small gropup of patients and mild pain in the knee joint most patients were benefited by this procedure. 200 cases were operated by wedge osteotomy at the level of tibialtuberosity, 125 below the level and 75 by dome osteotomy. Results were evaluated on the basis of Bailey knee assessment scale.  All patients were benefited by surgery as regards the relief of pain.  Very old and obese patients showed poor results after surgery due to their inability to do required physiotherapy.  Patients having symptoms for shorter duration of showing early evidence of radiological changes responded to surgery better as compared to those having advanced changes. Patient with 1-10º of postoperative valgus in tibio-femoral alignment obtained maximum pain relief and good range of motion. Over correction and failure to achieve valgus showed poor results.  75% of patients showed good results, 20% fair & 5% poor. According to Bailey Knee assessment scale 75% of patients showed good results, 20 % fair & 5% poor. Better resutls were obtained by dome osteotomy as comapred to wedge osteotomy regarding relief of pain, post oerpative range of knee motion, and abilities to walk distances, climb the stairs, squat or sit crosslegged. Osteotomy of fibula in dome osteotomy required special care to avoid complications like pain at fibular osteotomy site and weakness of dorsiflexion of foot. Thus high tibial osteotomy is a boon for early osteoarthritis of knee with unicompartmental involvement and to some extent with moderate to advance osteoarthritis in developing countries as clearly indicated in our study.

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