Abstract
Objective: Since 2004 we commenced opening wedge high tibial osteotomy (HTO) in our department for treating medial osteoarthritis of the knee for patients with high levels of daily activity. Based on this experience we evaluated the problems and improvements with this procedure.
Methods: Eighty-five patients with 118 knees were evaluated who underwent opening wedge HTO between February 2004 and December 2012, inclusive. The mean age of the patients was 64 years. The diagnosis of 87 knees were medial osteoarthritis and 31 knees were osteonecrosis of the medial condyle, respectively. In excess of half of the knees were at Hokkaido UNIV. system stages 2 or 3 preoperatively. Corrective osteotomy was performed at a femur-tibial angle of 170 degrees with a plate and hinge being used for fixation. Auto-transplantation of the iliac crest with conjugated β-tricalcium phosphate granules were used for bone grafting.
Results: Two patients' knees required reoperation due to the loss of correction resulting from malunion, and one patient who underwent simultaneous bilateral opening wedge HTOs was later converted to total knee arthroplasties due to over-correction.
Conclusion: With careful selection of patients with indications for knee surgery, good short-term and intermediate-term results can be achieved by medial opening wedge HTO. Further evaluation of this procedure is required for long-term surgical outcome.
