[Medial closing wedge osteotomy for correction of valgus deformity].

OBJECTIVE

Correction of a proximal tibial valgus deformity.

INDICATIONS: Lateral osteoarthritis of the knee or cartilage damage in a valgus deformity > 5° with a medial proximal tibial angle (MPTA) > 90°.

CONTRAINDICATIONS: Medial proximal tibial angle < 90°, medial cartilage damage, medial meniscus loss.

SURGICAL TECHNIQUE: Skin incision medial of the tibial tuberosity approximately 8-10 cm. Insertion of two converging guidewires directly above the pes anserinus, ascending obliquely, and ending at the tip of the fibula. Control of the wire position with the image intensifier. Osteotomy with an oscillating saw. Removal of the wedge and closure of the osteotomy. Osteosynthesis with a medial angle-stable plate.

POSTOPERATIVE MANAGEMENT: Partial load bearing with 10-20 kg for 2 weeks, then step-wise increase in load. Mobility: free.

RESULTS

We performed this surgery in the manner described in 21 patients with lateral osteoarthritis or cartilage damage (17 men, 4 women, average age: 51 years). The valgus deformity was reduced from an average of 5.6 to -0.5°. The KOOS-PS (Knee Injury and Osteoarthritis Outcome Score-Physical Function Short-form) score decreased significantly from 39.1 ± 14 to 25.8 ± 20 points.