Jae Ang Sim; Beom Koo Lee; Dong Koo Kim

doi:10.4055/jkoa.2007.42.1.84

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Sim, Lee, and Kim: A Short Term Follow-up of Open Wedge High Tibial Osteotomy using Locking Compression Plate®

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2007; 42(1): 84-90.

Published online: 28 February 2007

DOI: https://doi.org/10.4055/jkoa.2007.42.1.84

A Short Term Follow-up of Open Wedge High Tibial Osteotomy using Locking Compression Plate®

Jae Ang Sim, M.D., Beom Koo Lee, M.D., Dong Koo Kim, M.D.

Department of Orthopaedic Surgery, Gachon University Gil Medicial Center, Incheon, Korea.

Address reprint requests to Beom Koo Lee, M.D. Department of Orthopaedic Surgery, Gachon University Gil Medical Center, 1198, Guwol-dong, Namdong-gu, Incheon 405-760, Korea. Tel: +82.32-460-3384, Fax: +82.32-468-5437, bklee@gilhospital.com

Abstract

Purpose

To evaluate the value of an open wedge high tibial osteotomy (HTO) using a Locking Compression Plate® (LCP®) as a surgical technique.

Materials and Methods

From May, 2003 to January, 2005, eleven open wedge HTO using LCP® were performed and the average follow-up period was 17.8 months. The knee score and function score for the clinical results, and the degree of varus deformity, the size of the joint space, the posterior tibial slope and the medial instability for radiography results were evaluated.

Results

The knee score improved from 54.8 points to 95.9 points, and the function score improved from 57.3 points to 88.2 points. The femorotibial angle was corrected from 4.1° varus to 9.9° valgus. The posterior tibial slope did not show any significant change. The size of the joint space increased from 3.3 mm to 4.3 mm. No medial instability was observed.

Conclusion

An open wedge HTO using LCP® achieved a corrected angle, reduced loss of the corrected angle, and an improved knee function. The surgical technique prevented the posterior tibial slope from increasing.

Keywords: Knee, High tibial osteotomy, Open wedge, Locking Compression Plate®

Figures and Tables

Fig. 1

Operative technique. (A) The pes anserinus was detached and the superficial MCL was detached from the poximal tibia (arrow: superficial MCL, arrow head: pes anserinus). (B) The increase in the posterior tibial slope was prevented by distracting the posterior site of the osteotomy.

Fig. 2

A 43-year-old woman with left knee osteoarthritis. (A) Preoperative weight bearing anteroposterior view shows that the femorotibial angle is varus 4° and the size of the medial joint space was approximately 2 mm. (B) 2.5 years-postoperative weight bearing anteroposterior view shows that the femorotibial angle is valgus 11° and the medial joint space has increased by 4 mm. (C) Preoperative lateral view shows that the posterior tibial slope is 9°. (D) 2.5 year-postoperative lateral view shows that the posterior tibial slope is 8°.

Fig. 3

At postoperative 2.5 years, 0° (A) and 30° (B) valgus stress view does not show a significant difference, when compared with the opposite side.

Table 1

Patient's Profiles

-, varus tibiofemoral angle;+, valgus tibiofemoral angle 1; ^*, same patient.

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