In the case of patients suffering from medial compartment osteoarthritis of the knee, a high tibial osteotomy is the preferred treatment for preserving the knee articulation and correcting the knee biomechanical axis. Nowadays, the open wedge high tibial osteotomy is the preferred surgical technique for treating patient with varus knee angulation. The procedure consists in creating a medial gap in the proximal tibial metaphysis that is filled with autologus bone graft or bone substitutes. Synthetic bone substitutes made by bioceramics like hydroxyapatite or tricalcium phosphate are becoming more popular. Tricalcium phosphate (TCP) used as a bone substitute has shown to have osteoconductive properties and it is resorbable. We describe our experience in Orthopaedics III Department of the Clinical Emergency Hospital Bucharest, where we treated a total of 26 patients suffering from medial compartment osteoarthritis of the knee with high tibial open wedge osteotomy, between 2011 and 2015. TCP wedge implants were successfully used as bone substitutes for the tibial medial osteotomy in conjunction with a proximal tibia plate and screws. Open wedge high tibia osteotomy used for correcting the biomechanical axis of the lower limb is a safe surgical procedure that preserves the anatomical knee joint.
Role of high tibial osteotomy in medial compartment osteoarthritis of the knee: Indications, surgical technique and outcomes
