Abstract
Introduction: To compare the effect of complete and incomplete osteotomy of the medial cortex of proximal tibia in closing wedge high tibial osteotomy
Materials and methods: Total 153 cases of high tibial osteotomy (average age: 59.7 years) were divided into two groups: Group I; 57 cases of incomplete osteotomy of medial cortex and Group II; 96 cases of complete osteotomy. All osteotomies were fixed with 90¨¬angled blade plate. Two groups were evaluated to verify the difference of complete and incomplete osteotomies regarding the radiological changes of the mechanical axes.
Results: After average 3.5 years of follow-up (minimum 2.4 years), Group I showed recurrence of varus in 21 cases (36.8%) with average 10¨¬ correction loss, while Group II showed recurrence of varus in 11 cases (11.5%) with average 3¨¬ correction loss(P< 0.05). The blade plate fixation of high tibial osteotomy was not rigid enough to prevent loss of correction in case of osteoporosis of the proximal tibia as far as the medial cortex was left intact.
Conclusion: Authors recommend complete osteotomy of the medial cortex in closing wedge high tibial osteotomy in order to maintain the valgus correction by avoiding the spring effect of medial cortex. Blade plate fixation also provides more physiological tibiofemoral axis for future total knee surgery by lateral translation of the distal tibia after complete osteotomy of medial cortex.
The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.
