Fixator-Assisted Nailing for Acute Correction of Periarticular Knee Deformities (Pilot Study)

The main purpose is to assess the radiological and clinical outcomes of acute deformity correction using fixator-assisted nailing in periarticular angular knee deformities.

We recruited a small number of cases (ten patients) with angular knee deformities for a pilot study. We excluded skeletally immature patients, limb length discrepancy requiring lengthening, advanced knee osteoarthritis, and contraindications of nailing. The mean follow-up period was 24 months.

All radiographic parameters showed a statistically significant improvement (P value < 0.001) in total deformity angle, mechanical axis deviation (MAD), mechanical lateral distal femoral angle (mLDFA), and Mechanical medial proximal tibial angle (mMPTA). The mean total deformity angle was corrected from 19.12 degrees (± 8.43) to 5.15 degrees (± 5.27). The mean MAD decreased from 3.3 cm (± 7.72) to -1.4 cm (± 2.8). Two patients had postoperative subtrochanteric fracture. There was a single case (10%) of residual under-correction.

Fixator-assisted nailing is an effective minimally invasive technique for acute correction of periarticular knee angular deformity. This technique showed satisfactory clinical and radiological short-term outcomes. However, the technique is technically demanding with a steep learning curve, time consuming, and expensive with higher radiological exposure, but ensures intraoperative accurate control in deformity correction and can be suitable technique with multiple CORA deformities and to operate tibia and femur with the same incision if needed.