Opening-wedge high tibial osteotomy without bone graft.

Area of Science:

• Orthopedic Surgery
• Biomechanics
• Knee Osteotomy

Background:

• Varus knee deformities are commonly treated with open wedge high tibial osteotomy.
• Traditional methods often require bone grafts or substitutes, leading to morbidity and delayed healing.

Purpose of the Study:

• To evaluate the efficacy of medial opening-wedge high tibial osteotomy without bone grafting for varus knee correction.
• To assess healing time, union rates, and clinical outcomes in patients treated with this technique.

Main Methods:

• A consecutive series of 58 patients underwent medial opening-wedge high tibial osteotomy with internal fixation (wedge plate and screws).
• No bone graft or bone substitutes were used.
• Patients ranged from 24 to 65 years old, with osteotomy openings from 8 to 14 mm.
• Follow-up averaged 38 months.

Main Results:

• All 58 osteotomies achieved union, with an average healing time of 12.4 weeks.
• Excellent or good outcomes (HSS score) were reported in 100% of knees.
• A significant correlation was found between osteotomy opening size and healing time.

Conclusions:

• Medial opening-wedge high tibial osteotomy up to 14 mm is a viable option without bone grafting.
• This approach simplifies the procedure, reduces operative time, and avoids graft-related complications.
• The technique demonstrates high union rates and excellent clinical results for varus knee deformity correction.