Minimally Invasive Open Wedge High Tibial Osteotomy with Press-Fit Tricortical Bone Graft
Bancha Chernchujit MD*, Thongchai Suntharapa MD*, Sunyarn Niampoog MD*, Yongyuth Siripakarn MD*
Affiliation : * Department of Orthopedics, Faculty of Medicine, Thammasat University, Bangkok, Thailand
Background : Numerous operative procedures has been described for high tibial osteotomy (HTO), however
the HTO without implant fixation has never been reported.
Objective : The objective of this study was to propose a new technique and evaluate the preliminary results.
Material and Method: Prospective review study on a series of case, at the Hospital. Seventeen patients (10
females, 7 males), and a total of 18 knees with a mean age at the operative time of 53 years (range, 35 to 64
years) were available for follow-up evaluation at a minimum of 24 months. The open-wedge HTO with press-
fit tricortical bone graft was performed by one surgeon.
Results : The average time to union was 8.5 weeks (range, 6 to 12). There was one case of delayed union
(5.5%). No nonunion, grafts collapse or dislodge were found. The average preoperative varus deformity was
8 degrees (range 6 to 11) and postoperative valgus was 8 degrees (range, 6 to 13). The pre and postoperative
average pain level were 8.7 (range, 7 to 10) and 3.6 (range, 0 to 7), respectively. The average satisfaction
score of the patients was 77 % (range 50-100%). The average Knee Society Score was 82.3 + 6.4.
Conclusion : Considering its less morbidity, excellent cosmesis, no need for second operation to remove the
implant, excellent cost effectiveness and no complications from internal fixation, this new technique offers an
attractive alternative in HTO.
Keywords : Open-wedge, High tibial osteotomy, Press-fit, Tricortal bone graft
