Medial Opening Wedge High Tibial Osteotomy using the Puddu Plate without Graft in Patients with Varus Deformity

M.O.Hegazy, A.S.El-Gazaar, S.E.Bayomy, M.A.Abo El-Enin"


A medial open wedge high tibial osteotomy (MOWHTO) is a precious surgical procedure that correct varus deformity related to Knee Osteoarthritis (OA). It consistently provides relief in knee pain and improves knee function. This performance is recommended for active, middle and old aged patients with isolated medial cityand hence is now a preferred choice of High tibial osteotomy (HTO). This study was conducted on 10 patients with HTO in unicompartmental osteoarthritis in the medial joint space with varus deformity. The youngest patient was 15 years and the oldest was 55 years old. The mean age was 35 years; using the Puddu plate fixation without graft. Mean follow-up period was 6 (range 5–7) months. Full consolidation was achieved at the osteotomy site. These include appearing of trabecular formation, bridging of bone ends, and corticalization of three of the four sides at least as seen on anteroposterior and lateral radiographs. Cartilagenous tissue in the lateral compartment was intact and of good quality. There was no observation of any plate failure at the end of third month. HSS score was obtained for each patient preoperative and monthly post-operative till the 6th month.The Puddu plate fixation without graft approach is a procedure looked as a gold standard technique to many surgeons because of the small incision and the simple surgical steps. Open-wedge osteotomy of the tibia can be performed without bone grafting or bone substitution in most cases.

Key words

Puddu plate, High tibial osteotomy, Varus deformity.