PUDDU OPEN WEDGE HIGH TIBIAL OSTEOTOMY FOR OSTEOARTHRITIS OF THE KNEE.

Abstract

Purpose: This study documents the short term follow-up of a group of patients with unicompartmental osteoarthritis with associated collateral ligament laxity. there are currently few studies documenting the indication and results of open wedge high tibial osteotomy.

Methods: A retrospective assessment of 52 cases of open wedge high tibial osteotomy ws carried out of cases performed between 1999–2003. The average follow-up was 4.5 years and the mean age was 38 years. We selected cases with varus alignment and laxity of the medial collateral ligament. Clinical evaluation was carried out using the HSS knee rating score. Clinical laxity pre and post-op was noted, as well as range of motion, quads bulk and swelling. Pre and post-op 3 foot standing x-rays were carried out to assess alignment.|The Puddu open wedge osteotomy was used in all cases with autogenous bone from the iliac crest. Supplemental fixation of the opposite side of the tibia was used if there was any tendency to open.

Results: Open wedge high tibial osteotomy for unicompartmental osteoarthritis with ligament laxity treats both problems. The change in alignment deals with the arthritic symptoms and the opening wedge tensions the collateral ligament.|Of the 52 cases, 44 are good to excellent with 2 non-unions and 3 cases converted to total knee replacement.

Conclusions: Open wedge high tibial osteotomy can deal effectively with selected cases of unicompartmental osteoarthritis with secondary collateral ligament laxity.