Clin Orthop Surg.  2010 Mar;2(1):47-54. 10.4055/cios.2010.2.1.47.

The Short-term Follow-up Results of Open Wedge High Tibial Osteotomy with Using an Aescula Open Wedge Plate and an Allogenic Bone Graft: The Minimum 1-Year Follow-up Results

• Lee SC
• Jung KA
• Nam CH
• Jung SH
• Hwang SH

• KMID: 1110349
• DOI: http://doi.org/10.4055/cios.2010.2.1.47

Abstract

BACKGROUND: This study examined the results of open wedge high tibial osteotomy with using an Aescula open wedge plate and an allogenic bone graft as a surgical technique for the patients who suffer from osteoarthritis of the knee with a genu varum deformity.
METHODS
From March 2007 to August 2007, 33 patients (37 cases) with osteoarthritis of the knee and a genu varum deformity underwent a high tibial osteotomy with using an Aescula open wedge plate and an allogenic bone graft. The patients were followed up for more than 1 year. Before and after surgery, the correction angle of the genu varum was measured by the lower extremity scannogram and the posterior tibial slope, the joint space distance and the time to bone union were evaluated. The functional factors were evaluated using the Knee Society Score.
RESULTS
The average knee score and function score improved from 52.19 +/- 11.82 to 92.49 +/- 5.10 and 52.84 +/- 6.23 to 89.05 +/- 5.53, respectively (p < 0.001). According to the lower extremity scannogram, the mean preoperative varus angle was -1.86 +/- 2.76degrees, and the average correction angle at the last follow-up was 10.93 +/- 2.50degrees (p < 0.001). The tibial posterior slope before surgery and at the last follow-up were 8.20 +/- 1.80degrees and 8.04 +/- 1.30degrees, respectively (p = 0.437). The joint space distance increased from 4.05 +/- 1.30 mm to 4.83 +/- 1.33 mm (p < 0.001). The average time to complete bone union was 12.69 +/- 1.5 weeks.
CONCLUSIONS
An open wedge high tibial osteotomy using an Aescula open wedge plate and an allogeneic bone graft to treat osteoarthritis of the knee with a genu varum deformity showed good results for the precision of the correction angle, the time to bone union and the functional improvement.

Keyword

Osteoarthritis; Genu varum; High tibial osteotomy; Aescula open wedge plate; Allogenic bone graft

MeSH Terms

Adult
Arthroscopy
*Bone Plates
*Bone Transplantation
Female
Humans
Joint Deformities, Acquired/diagnosis/etiology/radiography/*surgery
Knee Joint
Male
Middle Aged
Orthopedic Procedures/*methods
Osteoarthritis, Knee/complications/diagnosis/radiography/*surgery
Osteotomy/*methods
Tibia/radiography/*surgery
Transplantation, Homologous

Figure

• 

  Fig. 1 The anterior border of the medial collateral ligament was raised and peeled off from the bone with using a periosteal elevator to expose the posteromedial crest of the tibia.

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  Fig. 2 Photograph of the Aescula open wedge plates and screws.

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  Fig. 3 Allograft of the hemi-fem oral head (A) and design of the corticocancellous wedge allograft and the cancellous pieces (B).

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  Fig. 4 The corticocancellous wedge piece (the medial calcar portion of the allograft hemi-femoral head) was inserted into the area between the plates.

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  Fig. 5 Measuring the posterior tibial slope using the proximal tibial anatomical angle. The left preoperative lateral radiograph shows the posterior tibial slope. The right postoperative lateral radiograph shows no significant change in the posterior tibial slope at the end of 1 yr.

• 

  Fig. 6 Distal screw back-out was noted.

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