For osteoarthrosis of the knee unresponsive to medical treatment, the standard operative technique is to remove a wedge of the knee from the lateral aspect of the tibia. We describe a simple and precise procedure--medial open wedge high tibial osteotomy.
Between 1988 and 1991, we performed 25 medial open wedge high tibial osteotomies for osteoarthrosis of the medial compartment of the knee with varus deformity. Anterior tibial tubercle elevation (ventralization) was combined with the index procedure in 6 cases which were associated with patellofemoral arthrosis. To keep the osteotomy open a bicortical wedge-shaped graft from the iliac crest was used in 14 cases and from the tibia in 8 cases. Osteotomy was performed 2 cm distal to the articular surface of the tibia above the tibial tuberosity. Fixation of the osteotomy was not required.
Twenty-two patients were available for follow up examination and were assessed clinically and radiologically over a period ranging from 6 to 48 months (mean 22 months). Fourteen of them did well and 8 had fair results. No major complications were encountered.
Medial open wedge high tibial osteotomy not only has results comparable to other techniques but has several advantages of being a simple and accurate procedure with a low morbidity.