Abstract
High tibial osteotomy (HTO) is an established technique for treating medial osteoarhrosis and osteonecrosis of the knee. We performed opening-wedge HTO in 7 patients from March 2007 to April 2008. The mean age of the patients was 62.3 years (range 51-66 yr). The medial osteotomy site was fixed with a DynaFix VS osteotomy plate followed by grafting with porous 60%β-tricalcium phosphate (TCP).
The limb was not immobilized with a knee brace postoperatively and full weight bearing was allowed from the fourth week in principle, those lateral tibial plateau fractures were occurred in two patients during the surgery. The mean preoperative and postoperative femorotibial angle was 181.6 degrees and 170.7 degrees, respectivery. The mean JOA score improved from 57.7 to 77.1 points. There was no pseudoarthrosis or loss of correction.
Opening wedge HTO avoids fibro-osteotomy, lateral muscle detachment and leg shortening. The correction can be adapted intraoperatively based on an X-ray image of the whole lower extremity. Rigid fixation with the use of a medial DynaFix plete and 60%β-TCP allows early full weight bearing and discharge within four to five weeks after surgery. This is an effective, simple, precise, and less invasive procedure for busy middle-aged patients with medial gonarthrosis.
