J Korean Orthop Assoc.  2009 Jun;44(3):336-343. 10.4055/jkoa.2009.44.3.336.

Open Wedge High Tibial Osteotomy with Aescula(R) Plate

• Song EK
• Seon JK
• Park SJ
• Cho NY

• KMID: 2186342
• DOI: http://doi.org/10.4055/jkoa.2009.44.3.336

Abstract

PURPOSE: This study is to evaluate chinical and radiological results of open wedge high tibial osteotomy using Aescula(R) plate.
MATERIALS AND METHODS
Ninity one patients who have unicompartmental osteoarthritis with varus deformity were treated by open wedge high tibial osteotomy with Aescula(R) plate and followed up at least 2 years. Clinically, visual analogue scale (VAS), range of motion (ROM) and hospital for special surgery (HSS) score were evaluated. Radiologically, tibio-femoral angle, mechanical axis, medial proximal tibia angle and posterior slope were measured. All complications were also evaluated.
RESULTS
During the follow-up VAS improved from 8.3 to 2.1, ROM were checked preoperatively from 1.3degrees to 137degrees and from 1.8degrees to 136.1degrees at last follow up. And HSS score improved from 76.8 to 91. Preoperative tibio-femoral angle was 0.4degrees of varus, mechanical axis 6.4degrees of varus, medial proximal tibia angle 84.4degrees and posterior slope 9.3degrees. Radiologic results at last follow up revealed significant improvements by 8.3degrees of valgus for tibio-femoral angle, 1.8degrees of valgus for mechanical axis and 90.1degrees for medial proximal tibia angle. Mean posterior slope was 10.4degrees which increased 1.1degrees compared with preoperative one. And there was one fixation failure that needed re-operation.
CONCLUSION
Open wedge high tibial osteotomy using Aescula(R) provided excellent clinical and radiological results at 2 years follow-up.

Keyword

Unicompartmental knee osteoarthritis; Open wedge high tibial osteotomy; Aescula(R) plate

MeSH Terms

Axis, Cervical Vertebra
Congenital Abnormalities
Follow-Up Studies
Humans
Osteoarthritis
Osteotomy
Range of Motion, Articular
Tibia

Figure

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  Fig. 1 Aescula open wedge plate system. (A) Plate, (B) Screw, (C) Plate and screw.

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  Fig. 2 A comparision of tibial open wedge osteotomy. (A) Preoperative anteroposterior view with tibiofemoral angle. (B) Preoperative lateral view with posterior angle. (C) Teleoroentgenography with mechanical axis. (D) Postoperative antero-posterior view with tibiofemoral angle. (E) Postoperative lateral view with posterior angle. (F) Postoperative teleoroentgenography with mechanical axis.

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  Fig. 3 A procedure of high tibial open wedge osteotomy. (A) Skin incision below medial joint line. (B) Pes anserius tendon is identified and incised with Z-plasty fasion. (C) Identification of anterior border of medial collateral ligament. (D) Guide wire insertion under the fluoroscopy. (E) Osteotomy is performed along guider wire. (F) Gap measeurement and plate fixatioin.

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