Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Orthopaedic Surgery

Genu varum is a common deformity associated with medial compartmental osteoarthritic knee with subsequent mechanical axis deviation and stress isturbances across the knee joint. A preoperative measurement of the degrees of varus deformity is so essential to overcorrect the deformity and putting the knee in net valgus position 5 degrees. (1) Lateral closing-wedge HTO was initially preferred, but medial opening- wedge HTO is becoming popular because it is simpler and allows adjustment in the coronal and sagittal planes. In addition, medial opening-wedge HTO avoids possible damage to the lateral aspect of the knee (ie, the proximal tibiofibular joint and the peroneal nerve).(2) The ideal patient to perform HTO using the Puddu plate with graft aged below 60 years with unicompartmental osteoarthritis in the medial joint space, varus deformity less than 10 degrees with no flexion deformity and good patient motivation to comply with postoperative rehabilitation program. The benefits of this technique is the short time of operation in comparison with other techniques of corrective osteotomy, graft was used, no casting post operative because the Puddu plate gives rigid fixation which lead to early range of motion to the knee. The complications of HTO include undercorrection, delayed union or non union, infection, internal fixation problems, intra- articular fracture, thromboembolic diseases and vascular complications. (3)

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