Acta Orthop Traumatol Turc
Early results of medial opening wedge osteotomy in varus gonarthrosis
Abstract
Objectives: We evaluated the efficacy and short-term results of medial opening wedge high tibial osteotomy with the use of a Puddu plate in patients with medial compartment gonarthrosis.
Methods: The study included 15 knees of 12 female patients (mean age 50.6 years; range 45 to 63 years) who were treated with medial opening wedge high tibial osteotomy for varus knees with medial compartment gonarthrosis. The osteotomy sites were fixed with a Puddu plate followed by allograft application. The mean follow-up period was 30.7 months (range 19 to 40 months).
Results: The mean consolidation time was 7.1 weeks (range 6 to 9 weeks). The mean preoperative and postoperative Lysholm scores were 54.1 (range 30 to 60) and 82 (range 67 to 95), respectively. The mean preoperative femorotibial angle was 3.5° in varus malalignment (range 3° valgus to 9° varus). It was 7.3° valgus postoperatively. The mean correction of the mechanical axis was 10.7°, with no loss of correction during the follow-up period. No adverse effects were observed associated with allograft use. The lateral cortex was broken in one patient (%6.7) who was then treated with an Ilizarov external fixator due to pseudoarthrosis. All but this patient were satisfied with the treatment.
Conclusion: Compared with other osteotomy models, medial opening wedge osteotomy with the use of a Puddu plate offers advantages in terms of ease of application and maintenance of correction in the early follow-up period. With allograft application, consolidation is obtained without interfering with the rehabilitation period.
Methods: The study included 15 knees of 12 female patients (mean age 50.6 years; range 45 to 63 years) who were treated with medial opening wedge high tibial osteotomy for varus knees with medial compartment gonarthrosis. The osteotomy sites were fixed with a Puddu plate followed by allograft application. The mean follow-up period was 30.7 months (range 19 to 40 months).
Results: The mean consolidation time was 7.1 weeks (range 6 to 9 weeks). The mean preoperative and postoperative Lysholm scores were 54.1 (range 30 to 60) and 82 (range 67 to 95), respectively. The mean preoperative femorotibial angle was 3.5° in varus malalignment (range 3° valgus to 9° varus). It was 7.3° valgus postoperatively. The mean correction of the mechanical axis was 10.7°, with no loss of correction during the follow-up period. No adverse effects were observed associated with allograft use. The lateral cortex was broken in one patient (%6.7) who was then treated with an Ilizarov external fixator due to pseudoarthrosis. All but this patient were satisfied with the treatment.
Conclusion: Compared with other osteotomy models, medial opening wedge osteotomy with the use of a Puddu plate offers advantages in terms of ease of application and maintenance of correction in the early follow-up period. With allograft application, consolidation is obtained without interfering with the rehabilitation period.