[Extra-ligamentous valgisation additive tibial head osteotomy. Indications-technic-complications-errors. Critical...

Area of Science:

• Orthopedic surgery
• Biomechanics of the knee

Background:

• Posttraumatic or idiopathic gonarthritis often presents with varus deformity.
• Stable medial collateral ligaments are crucial for successful corrective osteotomy.

Purpose of the Study:

• To evaluate the efficacy and safety of valgus high tibia correction osteotomy (open wedge method) for varus knee deformities.
• To identify factors influencing complication rates, specifically infection.

Main Methods:

• Extraligamentary open wedge high tibia osteotomy using an autologous iliac crest bone graft.
• Bridging plate osteosynthesis for stability and early mobilization.
• Follow-up examination of 58 patients (64 osteotomies) operated between 1981 and 1986.

Main Results:

• An infection rate of 15% was observed at the tibial head.
• Infection was attributed to procedural application and performance, not the technique itself.
• Successful outcomes were achieved when adhering to specific surgical parameters.

Conclusions:

• Valgus high tibia osteotomy (open wedge) is a suitable treatment for unilateral varus gonarthritis and deformities.
• Strict adherence to osteotomy site, wedge size, indication, and technical execution is vital for minimizing complications.
• This method offers a viable alternative to other treatment options for varus knee deformities.