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Date of Graduation

8-3-2001

Degree Type

Capstone Project (On-Campus Access Only)

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

William Hatch, MS, PA-C

Abstract

An open-wedge high tibial osteotomy with an autograft from the iliac crest relieves pain and restores function in patients suffering from medial compartment osteoarthritis. This study was done to determine the effectiveness of using an allograft in this procedure. Since 1998 ten patients have undergone an open-wedge osteotomy with an allograft. A retrospective chart review was done on these patients, followed by a subjective survey and a physical examination. X-rays were also obtained at the time of examination. The data from the survey, physical examination, and x-rays were applied to the Hospital for Special Services Knee Rating Form to assign patients a score, either excellent, good, fair, or poor. At the time of examination 5 of the patients scored excellent, 3 scored good, I scored fair, and I scored poor. 70% of the patients were satisfied with their results, 10% were completely unsatisfied, and 20% were unsure. The second part of the study consisted of designing an osteotomy jig to assist in making precise cuts in an open-wedge osteotomy. Thirty adult x-rays were measured obtaining the mean anterioposterior diameter, coronal width, tibial tubercle height, and medial angle. These figures were then applied to the apparatus currently in the engineering design phase. This study showed that an allograft is effective in relieving pain, decreasing graft collapse, and provide adequate healing time, with over 50% of the patients satisfied with their results. Thus, using an allograft is an effective alternative for an open-wedge high tibial osteotomy.

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