Clinical and Radiographic Findings of Proximal Tibial Osteotomy Surgery Using Puddu-plate in People with Genu Varum

Abstract

Introduction: Tibial osteotomy (HTO) is an approved surgical technique for knee varus deformity. The purpose of this study is to investigate the clinical and radiographic results of proximal tibial osteotomy surgery using Puddu-plate in people with genovarum.

Materials and Methods: This cross-sectional study was conducted on patients referred to Firoozgar Hospital in Tehran, Iran who underwent proximal tibial osteotomy surgery using Puddu-Plate with the complaint of genu varum. Patients with a varus deformity caused by tibial bone and complain of pain underwent surgery. Patients were routinely visited and examined by X-RAY AP/LAT at intervals of 2, 6, 12 and 24 weeks after surgery and their information was recorded. An alignment view was taken from all patients after surgery at least at 24 weeks. In most patients, the alignment view was taken after the operation with an interval of more than one year, and the desired angles were measured and recorded.

Results: In this study, all patients finally found union and there were no intraoperative neurovascular complications, postoperative infection, or device failure. The correction of MPTA angles after the operation was statistically significant compared to before the operation (7.75; P=0.026). Considering that this measurement was at least 6 months after the operation and radiographic consolidation, it was still stable. Knee Joint Obliquity and Ankle Joint Obliquity increased in the present study after surgery compared to before surgery, but it was not statistically significant (P>0.05). Posterior tibial slop increased slightly after surgery compared to before surgery (3.66; P=0.001). The average time of full-weight-Bearing and union in the patients of this study was 12.53 and 12.64 weeks, respectively, and this parameter did not show a statistically significant difference in terms of gender and even age group.

Conclusion: Due to the acceptability of union rate, varus correction and Puddu-plate complications compared to other devices in various studies, it is recommended to use Puddu-plate for fixation in corrective open wedge high tibial osteotomy surgery, Specially, in patients with varus and postero lateral injury because of a mild increase in Tibial slope.