Results of High Tibial Osteotomy using A.Z. (Azhar's) Fixators in the Treatment of Medial Compartment Osteoarthritis of Knee Joint

Aim: To evaluate the results of High tibial Osteotomy using A.Z.(Azhar's) Fixator in the treatment of medial compartment Osteoarthritis of the knee joint. Place and duration of study: The study was conducted initially in the orthopaedic department Mayo hospital Lahore from 1988 to 1993 and then at Allama Iqbal Memorial Teaching Hospital, Sialkot from 1998 to 2010. Methods: Total 47 patients were selected for the use of AZ fixator after High tibial Osteotomy. The patients were operated initially at Mayo Hospital Lahore and later on at Allama Iqbal Memorial Teaching Hospital Sialkot. All patients were reviewed at AIMTH and were evaluated clinically according to Baily Knee rating scale and radiologically by measuring tibio femoral angle. The follow up range from form 5 years to 14 years with average follow of 7 years. Out of 47 patients operated 28 patients (59.75%) were male and 19 patients (40.42%) were female. The age range between 55 years to 75 years. The results of the patients evaluated by modified Baily Knee rating scale were excellent in 40 patients (85.10%), good 3 patients (6.38%) fair 02 patients (4.25%) and poor in 02 patients (4.25%). 45 patients (95.74%) stated that they were fully satisfied with the result of surgery. The average postoperative angle achieved 8 degrees of valgus. The complications were also noted. Out of 47 patient 05 patients (16.63%) had wound infection out of which pin track infection was present in 03 patients (6.38%) loosening of pin in 02 patients (4.25%). Peroneal Nerve Injury, Pseudarthrosis, delayed union, non union, compartment syndrome, fracture of proximal bone, loss of range of movement was not observed in any patient. There was considerable improvement in 38 patients (80.85%) in range of movement after high tibial osteotomy using A. Z Fixator. Conclusion: After post operatinve analysis of the patients using AZ fixator in high tibial osteotomy we reach to the conclusion that AZ fixator provide stable fixation and is easy to apply, cost effective, permit early range of movement, allows early weight bearing, promote bony union by giving, compression at osteotomy side, allow correction of post-operative under correction or over correction and also provide stable fixation till solid union is achieved by maintaining the correction upto desired period of time. It also prevent post-operativequadriceps wasting, joint stiffness, old age bed ridden complications like DVT, Pulmonary Embolism etc due to early mobilization. So we recommend that AZ fixator is safe and effective method of fixation as compared to other fixators. It is patient friendly keeping in view low socio economical conditions.