2.2. Case 2
A 59-year-old female patient who complained of serious pain in the left
knee and ipsilateral ankle for about one year presented at our clinic in
July 2019. She had no systemic musculoskeletal disease or other medical
history. She was 157.0 cm in height and 62.0 kg in weight, with a body
mass index of 25.2 kg/m2. The HSS score of the left
knee was 69. The osteoarthritic ankle stage was Takakura’s
classification stage 3.
Kellgren-Lawrence (K-L) grade II~III osteoarthritic
change of the left knee was documented. The weight-bearing X-ray showed
the varus deformity, and the hip-knee-ankle (HKA) angle was 4.5°. Her
ankle was noted to have 19.5° of varus TT and 5.2° of TI (Fig. 3).
Through a medial approach above the pes anserinus, an opening wedge HTO
was performed. Intraoperatively, the medial osteotomy wedge was opened
to 6° and the desired correction was achieved. The pain on the knee and
ankle joints had disappeared three months after HTO. The HSS score of
the left knee was 85 three months after surgery.
The postoperative weight-bearing X-ray showed favorable limb alignment
on the coronal view. The standing HKA angle improved from a preoperative
value of 4.5° to -1.4° at follow-up. The TT was corrected from 19.5° to
10.6° and the TI from 5.2° to 0.5° (Fig. 4).