Treatment of patients with arthrosis of the tibiofemoral and patellofemoral joints using the Ilizarov fixator

Purpose. To determine the efficiency of the proposed by us technique of surgical treatment of the patellofemoral and tibiofemoral joints using the Ilizarov fixator. Materials and Methods. The technique of simultaneous treatment of the patellofemoral and tibiofemoral joint osteoarthrosis using the Ilizarov fixator developed. This technique used in treatment of seven patients with Stage 3 patellofemoral and tibiofemoral joint arthrosis according to Kellgren classification. The patients’ age varied from 57 to 74 years. The technique of surgical intervention described. Results. When the patients examined one year after the treatment they had no complaints. Moreover, they walked without additional supports. The knee flexion was up to 40-50°, extension - to 180° (active). In the process of the knee flexion and extension the patellas moved freely along the midline without causing pain. Conclusion. The use of the proposed technique for treatment of patients with gonarthrosis allows simultaneous improvement of the conditions of functioning the knee both parts: tibiofemoral and patellofemoral. The advantage of this technique consists in the possibility of postoperative graduated elimination of the leg deformity components remaining after correction on the operation table before biomechanical axis normalization, and that of simultaneous traction of the separated tibial tuberosity fragment with attached to it patellar ligament by moving the fragment distal edge anteriorly. This surgery may be method of choice in treatment of patients with osteoarthrosis of the knee patellofemoral and tibiofemoral parts. The results are encouraging and allow to hope that the described technique will be used.