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Journal of Bone and Joint Surgery - British Volume, Vol 83-B, Issue 8, 1111-1115.
doi: 10.1302/0301-620X.83B8.11993  
Copyright © 2001 by British Editorial Society of Bone and Joint Surgery
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Open-wedge osteotomy of the proximal tibia with hemicallotasis

E. Nakamura, MD, PhD, Lecturer; H. Mizuta, MD, PhD, Associate Professor; S. Kudo, MD, PhD, Orthopaedic Surgeon; and K. Takagi, MD, PhD, Professor and Chairman

Department of Orthopaedic Surgery, Kumamoto University School of Medicine, 1-1-1 Honjo, Kumamoto 860-8556, Japan.

K. Sakamoto, MD, PhD, Orthopaedic Surgeon

Nanbu-Chuo Hospital, 6-2-24 Minamitakae, Kumamoto 861-4106, Japan.

Correspondence should be sent to Dr E. Nakamura.

Conventional high tibial osteotomy for osteoarthritis of the medial compartment of the knee with closed-wedge or dome osteotomy (DMO) may produce shortening of the patellar tendon and loss of inclination of the proximal tibial plateau or of the offset of the tibial condyle relative to its bony axis. This can make subsequent total knee arthroplasty technically demanding.

We undertook a prospective study comparing these changes after DMO with those after using open-wedge osteotomy hemicallotasis (HCO). A total of 50 knees with arthritis of the medial compartment in 46 consecutive patients was randomly allocated to either DMO or HCO. There were no significant differences between the groups with regard to age, gender, femorotibial angle before operation or the angle of correction.

Radiological studies showed that HCO caused little change in the length of the patellar tendon or the inclination angle of the tibial plateau, while after DMO both gradually decreased. The degree of tibial condylar offset increased in both groups, but less so in the HCO group.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General