The stable upper tibial osteotomy for the treatment of osteoarthritis knee: Lateral closing step wedge osteotomy (part I).

ABSTRACT

This study reviews the results of the lateral closing step wedge technique for upper tibial osteotomy and fixation with an osteotomy plate for the treatment of degenerative various osteoarthritic knee. This technique of osteotomy was used in 10 patients, two males and eight females whose ages ranged from 52-66 years. During the five years postoperative follow up, we found that postoperative casting was not necessary and the patients could move the knees after 3-5 days and full range of motion was noted in one and a half months. Among these 10 patients, both joint debridement and osteotomy were done in 4 patients suffered from osteoarthritis knees with excessive osteophytes and loose bodies in the joint cavity, the full range of motion was obtained in about two and a half months. The union of the osteotomy took two months in all 10 patients and between 2-8 months they could return to their daily activities with some intermittent knee pain which relieved by analgesic drugs or using a cane. After 8 months – 5 years, nine of ten patients had no knee pain, only one patent persisted mild knee pain. Roentgen appearances of the knees after one year showed a decrease of subchondrol bone sclerosis, and the widening of the medial joint space as well as stable knee joints.