An Innovative Biological Lock Step Plate for Medial Open Wedge High Tibial Osteotomy

Abstract

Background: In medial compartment osteoarthritis of knee, changing the axis of weight bearing by doing medial open wedge osteotomy such that, the mechanical axis passes through the Fujisawa point after surgery giving long term result that articular surface on medial side regenerates 11/2 times within 1-2 years, which may delay or obviate total knee replacement. After observing all complications of various implants, we have innovated a Biological Lock Step Plate for medial open wedge high tibial osteotomy, having excellent result and an advantage of early mobilisation. Material & Method: Seventy knees of 66 patients with Medial compartment Osteoarthritis knee operated using Biological lock step plate and autologous cancellous bone graft (M:F – 28:38; average age 49.29 ± 4.85 years [range 39-59 years]).Preoperative & postoperative radiographs and knee society scores were obtained, with average follow-up of 36.43 ± 15.02 months (2-5 years). Results: The average preoperative knee society scores were 59.11 ± 8.59 and 72.43 ± 9.66, respectively, compared with the postoperative averages of 93.17 ± 11.44 and 91.71 ± 8.19, respectively. Most knees 62 were excellent, 2 good, 2 fair and 4 poor rating. Patients were relieved of pain and started with partial weight bearing walking on 4th postoperative day and had resume their duties after 2 months without any activity restrictions. Conclusions: We recommend the use of our Biological lock step plate for Medial open wedge osteotomy, an ideal method for tackling Medial compartment Osteoarthritis knee in early age group, as it has 88.57% excellent result with relatively less complication rate (11.4%).