Surgical Treatment of Patients With Knee Pathology and Deformities of the Lower Extremities: А Systematic Review

Abstract

Background. In patients with knee pathology, a phased approach to surgical treatment is often used: first, corrective osteotomies and then, if necessary, arthroplasty. This technique allows achieving optimal results of treatment. The study aimed to determine promising methods of surgical treatment of patients with knee pathology and deformities of the lower limb axis. Material and Methods. Publication search was conducted in the databases of eLibrary, PubMed, and Scopus from 2000 to 2020 (a search period of 20 years) using the following keywords: deformity of the lower limb axis, deformity correction, and total knee arthroplasty. Demographic data of the patients, features of surgical techniques, and treatment results were analyzed. Results. The literature search identified 1,232 publications, of which 12 studies that analyzed a total of 2.428 patients were included in this review. The surgical treatment covered the period from 1987 to 2018. The average follow-up period was 64.17.4 months, the average patient age was 58.81.4 years, the average duration of surgery was 114.23.9 min, and the average volume of blood loss was 484.030.0 mL. The fixation period with a metal plate, from the moment of osteotomy to hardware removal, was on average 18.01.8 months. Conclusion. Corrective osteotomies can prevent or delay knee replacement by an average of 11.8 years. Osteotomy preceding total arthroplasty does not negatively affect the survival of endoprosthesis, and its results are comparable with the medium- and long-term results of primary arthroplasty.

Keywords

• limb axis deformity
• corrective osteotomy
• high tibial osteotomy
• total knee arthroplasty