Proximal open wedge tibial osteotomy fixed by puddu osteotomy plate combined with arthroscopic microfracture in medial gonathrosis of the knee with varus defomity

ABSTRACT

The material of this study consisted of 22 patients, 18 females and 8 males with a mean age of 46.4 years [range 35-50 years]. Preoperative physical examination included assessment of pain, tenderness, range of motion, varus deformity and presence of instability. Standing anteroposterior radiograph of both knees was performed to determine the degree of the tibio-femoral varus angle. All patients had arthroscopic debridement and micro-fracture for the degenerative cartilage combined with proximal open wedge osteotomy fixed by Puddu osteotomy plate. Autogenous bone graft was used to fill the wedges in all patients. Postoperatively the knee was mobilized in a CPM, patients were allowed non-weight bearing ambulation with knee brace. Partial weight bearing started at 6 weeks and full weight bearing at average 12 weeks. The combination of arthroscopic debridement and micro-fracture with proximal open wedge osteotomy fixed by Puddu wedge plate provided a simplified technique for treatment of medial gonarthrosis of the knee with varus deformity in patients less than 50 years old