High tibial opening wedge osteotomy for medial osteoarthritis of the knee,a new technique without graft and with a large bone contact: effect on healing time in a preliminary series of 33 cases

Purpose of the study We propose an original open wedge medial osteotomy of the upper tibia. This new technique, unlike conventional open wedge osteoto mies, allows a large bone contact surface without requiring graft filling. Material and method The new technique is based on two anterior and posterio r hemi-osteotomies instead of the single osteotomy with the classical techn ique. The two hemi-osteotomies join laterally but start medially at very di fferent heights on the tibia. The two hemi-osteotomies open a wedge but nev ertheless lead to a very large bone contact due to the slippage in a fronta l connecting frontal osteotomy. The technique uses a cutting guide to allow perfect orientation meeting the requirements of the operative plan. We stu died prospectively the first 33 patients who underwent this new procedure i n two centers (Jouvenet Clinic and Tenon Hospital, Paris). We report here t he effect on healing time. Results There was one failure (retarded healing and partial loss of correct ion) due to incomprehension of the postoperative instructions. The other 32 cases consolidated in 45 days. No graft tilling was needed.