M. Blaysat, D. Saragaglia, N. Mercier, M. Grimaldi (Échirolles)
Purpose: the goal of this article was to present the clinical and radiological results of 42 severe genu varum operated on between August 2001 and June 2010 using computer navigation.
Methods: all the osteotomies were navigated using the Orthopilot® device (B-Braun-Aesculap, Tuttlingen, Germany). The procedure was performed as follows: after inserting the rigid-bodies and calibrating the lower leg, we did first the femoral closing wedge osteotomy (from 4 to 7 mm) which was fixed by an AO T-Plate, and secondly, after checking the residual varus, the tibial opening wedge osteotomy using a Biosorb® wedge (β Tricalcium phosphate, SBM, Lourdes, France) and a plate (AO T-plate or C-plate)
Results: all the patients were assessed at a mean follow-up of 46 +/- 27 months (12-108). The mean Lyshölm-Tegner score was 83.3 +/- 7.5 points (62-91) and the mean KOOS score was 95.1+/- 3.2 points (89-100). 40 patients were satisfied (22) or very satisfied (18) of the result. Regarding the radiological results, the goal was reached in 92.7% of cases and the mean HKA angle was 181.83° +/- 1.80° (177°-185°). At that mid-term follow-up no patient had revision to a total knee arthroplasty.
Conclusion: computer-assisted double level osteotomy in severe genu varum, is a reliable, reproducible, and accurate technique. This procedure, which is very delicate, especially in reaching pre-operative objectives, is simplified by computer-assistance.