The stable upper tibial osteotomy for treatment of osteoarthritic knee (part III): The simplified medial opening step wedge technique.

This study reviews the simplified medial opening step wedge technique for upper tibial osteotomy by performing the operation without osteotomy of fibula and using narrow straight plate instead of T-plate fixation of the tibia. During 1991-1993, this simplified osteotomy technique was used in 19 patients 2 males and 19 females with age ranged 51-69 years old, whose 21 knees had degenerative varus osteoarthritic, 15 right and 6 left knees. Among these 19 patients, both joint debridement of the knees and the osteotomy were done in 2 patients suffered from osteoarthritic knees with excessive osteophytes near the joint surface. The result of 1-2 year follow up showed that the technique provided increased stability of osteotomy site, decreased postoperative swelling and pain during exercise and ragne of motion of the knees. Moreover, it could reduce the operative time. For the union of osteotomy, radiologic changing appearance of the knees and used the knees in daily activities were similar to the results of the treatment of osteoarthritic knees by technique of medial opening and lateral closing step wedge upper tibial soteotomy.