[Closing-wedge high tibial osteotomy with a modified Weber technique].

Area of Science:

• Orthopedic Surgery
• Biomechanics
• Reconstructive Surgery

Background:

• Medial gonarthritis involves progressive degeneration of the knee's medial compartment.
• Varus deformity shifts mechanical load to the medial femorotibial compartment, exacerbating arthritis.
• Surgical intervention aims to realign the knee's mechanical axis to reduce medial compartment stress.

Purpose of the Study:

• To evaluate a surgical technique for decelerating medial gonarthritis progression.
• To investigate the impact of transferring the mechanical load axis to the lateral compartment.
• To reduce compressive stresses within the medial femorotibial compartment.

Main Methods:

• Retrospective analysis of patients with early-stage medial gonarthritis and symptomatic varus deformity.
• Surgical technique involves lateral approach subcapital fibular osteotomy and tibial tuberosity osteotomy.
• Correction of the mechanical load axis is achieved by excising a lateral-based bone wedge and achieving compression.

Main Results:

• Kaplan-Meier survival analysis demonstrated a correlation between patient activity level and long-term survival rate (10-15 years post-osteotomy).
• The extent of correction achieved during surgery directly influences the long-term outcome.
• The described surgical technique aims to preserve the medial compartment by offloading it.

Conclusions:

• Surgical realignment of the mechanical axis is effective in managing medial gonarthritis.
• Patient activity level and surgical correction extent are critical factors for long-term success.
• This approach offers a method to decelerate gonarthritis progression in select patients.