Open Wedge High Tibial Osteotomy with Allogenous Bone Graft

ABSTRACT

PURPOSE: The purpose was trying to clarify utility of allogenous bone graft on open type high tibial osteotomy, among the method of treatment of osteoarthritis with genu varum deformity. MATERIALS AND METHODS: Working with eight patients who have osteoarthritis with genu varum deformity, performed the open type high tibial osteotomy. and after transplanting allogenous bone graft, fixed using L-shaped plate. Before and after the operation, measured the degree of correction of genu varum through radiography of anterior and posterior of weigh load, understudied degree of union by testing bone histology during removal of implant, and evaluated functional factor as well as improvement of patients using Lysholm's knee score and HSS knee score. RESULTS: According to radiography of anterior and posterior of weigh load, the average of varus angle was 5.3 +/- 3.2 degrees before operation, the average of correction angle was 16.1 +/- 4.1 degrees after operation and the average of valgus angle was 10.7 +/- 4.3 degrees. By radiography of anterior and posterior of weigh load and lateral taken during the continual observation, complete bone union was seen. It got result that bone histology of transplanted part was composed of osteologic tissue and ratio of live bone and dead bone was 3.31, which live bone was 76.7 +/- 8% by image analyzer (Pro Plus(R) system) during the implant removal. The average of correction loss angle was 1.5 +/- 1.0 degrees After 15.3 months, average period of observation, average of Lysholm's score and HSS knee score were increased from 66.2 +/- 8.3 to 75.7 +/- 9.1 and from 55.2 +/- 9.0 to 79.0 +/- 7.5 respectively. CONCLUSION: The method that using a transplantation of allogenous bone graft on open type high tibial osteotomy, can be a fine surgical technique because it gains a perfect union, has an inconsiderable loss of correction angle and precision of correction angle, and can be contributed to the improvement of functional knee joint.