High Tibial Osteotomy With/Without Fulkerson Osteotomy in Knee OA

Centre of Postgraduate Medical Education

Status: Unknown

Conditions: Patellofemoral Disorder; Osteoarthritis, Knee

Treatments: Procedure: High Tibial Osteotomy

Study type: Interventional

Funder types: Other

Identifiers

NCT05128864

HTO_fulkerson

Details and patient eligibility

About

This study will compare Hight Tibial Osteotomy with or without Fulkerson Osteotomy performed on patients with early stages of Osteoarthritis with patellofemoral joint disorders. The purpose of this study is evaluate which type of osteotomy provides better clinical, radiological and laboratory outcomes.

Full description

Progression of knee cartilage degenerative changes leads to necessary total knee arthroplasty in future, which is the most popular procedure for treating OA. HTO applied at early stages of osteoarthritis allow slow down cartilage degeneration process, but the choice of performed surgery depends on surgeons personal assessment. Patellofemoral Pain Syndrome often occurs with knee arthritis. Antero-medialisation of tibial tubercle is frequent procedures for patella maltracking. So far, both, HTO and Fulkerson osteotomy was performed separately, even if patient have symptoms from patellofemoral joint and OA. The investigators believe that simultaneously surgery of HTO and fulkerson Osteotomy provides better outcomes and significantly slow down knee degeneration.

Enrollment: 110 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Knee medial compartment or patellofemoral osteoarthritis in medical interview and physical examination
• Confirmation of cartilage degeneration/damage and knee malalignment in radiological tests

Exclusion criteria

• no informed consent to participate in the study
• age under 18 years or above 65
• multi ligament injury or single plane knee instability
• another musculoskeletal disorders in lower limb
• lower limb deformity requiring axis correction below 4o or above 12.5o
• joints inflammatory diseases
• ASA score > II

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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110 participants in 2 patient groups

HTO and Fulkerson

Active Comparator group

Description:

High Tibial Osteotomy with Antero-medialisation of Tibial Tubercle

Treatment:

Procedure: High Tibial Osteotomy

HTO

Sham Comparator group

Description:

Descending Hight Tibial Osteotomy

Treatment:

Procedure: High Tibial Osteotomy