Acute Correction of Varus Knee by Biplanar medial Opening-Wedge high tibial osteotomy and Fixation with Tomfix Plate

Background: The biplanar medial opening wedge high tibial osteotomy (MOWHTO) a proper treatment method for symptomatic varus knee deformity allow adequate control of correction of varus knee, however, among its drawbacks is the tendency to decrease patellar height and increase the posterior tibial slope.

Aim: The aim of this work is to describe a technical ofbiplanar (MOWHTO) additionally, the described order of osteotomy fixation by tomofix plate regarding the accuracy of the planned correction and better control of the postoperative tibial slope.

Patients and Methods: A prospective study of 13 patients presented by varus knee deformity (8 male, 5 female) average age 31.69 years (17-45) who underwent the procedure between March 2016 and March 2017.The patients were assessed on the basis of pre and post-operative Knee and function scores, mechanical femorotibial angle (mFTA), posterior tibial slope angle (pTSA), range of motion and radiological evidence of healing of the osteotomy site. Follow up period was average12 months (12-18M).

Results: The knee score and functional score improved from the preoperative mean of 45, 41 respectively to mean postoperative was 75, 72 points .The average knee flexion was 115 (Range 100 –120) which at the final follow-up remained unchanged except one case complicated by limited full extension about 5 degrees. The mean preoperative Tibio-Femoral angle was 13.5º varus and postoperative was 3º valgus.

Conclusion: The biplanar High tibial Osteotomy allows preservation of posterior tibial slope, while correct the varus knee adequately.

Keywords: Varus knee, Biplanar medial opening-wedge high tibial osteotomy, Tomofix plate.