The clinical and radiological results of open wedge high tibial valgus osteotomy: short term results

Yoon, Kyoung Ho; Bae, Dae Kyung; Park, Jae Wan; Hwang, Dac Woo; Park, Hyun Chul; Oh, Hoon

Abstract

PURPOSE: The purpose of this study is to evaluate clinical and radiological results of open wedge valgus high tibial osteotomy without bone graft in varus knees with osteoarthritis or chondral defect of medial compartment.
MATERIALS AND METHODS
We reviewed 27 cases in 24 patients who underwent open wedge valgus high tibial osteotomy without bone graft in varus knees with osteoarthritis or chondral defect of medial compartment. Patients who had malalignment of femur, varus deformity due to ligamentous injuries, and concomitant autologous chondrocyte implantation or meniscus transplantation were excluded. There were 4 men and 20 women, mean age was 47.3 years old. Minimum follow-up period was 1 year(1 year to 4 year 9 months). we did arthroscopic debridement before the osteotomy in all cases. Results were radiologically evaluated by the joint obliquity, mechanical axis, femorotibial angle, time to bone union, and leg length, and clinically by range of motion, Lysholm scores, and subjective pain scales.
RESULTS
The joint obliquity in coronal plane improved varus 9.6 to varus 1.9 degrees. The posterior tibial slope in sagittal plane increased 7.9 to 10.7 degrees. The mechanical axis improved 13.2 to 61.1%. The femorotibial angle improved varus 3.9 to valgus 7.4 degrees. The leg length increased 80.6 to 81.6 cm. The mean plate size was 10.5 mm. The mean period to bone union is 3.9 months(3 to 7 months). Range of motion changed 135.4 to 135.0 degrees. The mean Lysholm knee scores improved 54.6 to 84.3 points. The subjective pain scales improved 50.7 to 85.4 points.
CONCLUSION
The open wedge high tibial valgus osteotomy in varus knees with osteoarthritis or chondral defect of medial compartment is useful procedure to reduce pain, to correct mechanical axis, femorotibial angle and joint obliquity in coronal plane, and to obtain bony union without bone graft. But the increase of the posterior tibial slope in sagittal plane and lengthening of tibia may develop.