In:
Surgical Case Reports, Science Repository OU
Abstract:
Background: Opening wedge high tibial osteotomy (OWHTO) is accepted and commonly used procedure in selected patients with medial osteoathrosis in the varus knee. The aim of this study is to demonstrate that OWHTO can be performed without graft interposition to filling the osteotomy defect and we evaluate bone union, its complications (delayed or nonunion), and functional results.
Materials and Methods: This is a continuous retrospective study of patients treated by OWHTO from July 2008 to August 2018. OWHTO was performed using a 4 holes wedges-plate of Puddu without interposition of graft. HKA angle was assessed preoperatively and postoperatively and at 3 months. Clinical and radiological follow-up at 6 weeks, 3 months and 6 months assessed consolidation in terms of filing the defect of the osteotomy according to the method recommended by Brosset. Results: Mean age was 53.2 years. Mean body mass index was 24, 8 and 30% of patients had BMI 〉 30. The average varus was 171° (165°-177°); postoperatively, the HKA angle was 182° (176°-186°). Radiological union occurred on average after 3.5 months, with a minimum of 2 months and a maximum of 5. The time to union was 3.7 months for opening wedges of more than 10° and 3.4 months for opening wedges of 10° or less. 9 patients showed delayed union; in all these cases the lateral cortex was broken initially (stage II Takeuchi) with large correction 〉 10°, 4 of them had BMI 〉 30.
The IKS knee score increased from 69 to 90 and the functional score increased 84 to 95 with 95% of patients scoring between 92 and 97. Conclusion: OWHTO without graft interposition using a wedges plate can be considered an alternative in the treatment of medial osteoarthritis of the varus knee, enabling the correction of the deformity and improvement of the clinical picture. Precautions must be taken event of large correction 〉 10° and unstable lateral cortex fracture (stage II Takeuchi).
Type of Medium:
Online Resource
ISSN:
2613-5965
,
2613-5965
DOI:
10.31487/j.SCR.2021.04.02
Language:
Unknown
Publisher:
Science Repository OU
Publication Date:
2021
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