Medial Open Wedge High Tibial Osteotomy for Varus Arthritic Knees by Dynamic External Fixator System (Distraction Callotasis)

Introduction: Varus arthritic knee is a major disabling condition in a relatively younger individual. Fixator assisted medial open wedge osteotomy has been found to be a good modality of treatment with promising results. Material & methods: In last 6 years total 52 patients with varus arthritic knee were treated with medial open wedge HTO fixed with external fixator and gradual distraction. The required degree of correction was calculated pre-operatively on a long axis weight bearing films. Distraction of Osteotomy was started at 1 week post operatively and continued till desired degree of correction was achieved. Patients were assessed clinically and radiologically by check X-rays periodically. Fixator was removed after satisfactory consolidation of osteotomy site on x-ray and results were assessed. The follow-up ranged from 3 months to maximum of 6 years. Results: Excellent pain relief was obtained in 43 patients out of 52. Four patients had good pain relief and 3 patients were not satisfied and had persistent symptoms. One patient had loss of correction after removal of fixator and 1 had over-correction. Pin-tract infection was found in 2 patients. None of the patients had non-union of osteotomy or conversion to TKR till last follow-up. Conclusion: Medial open wedge osteotomy with dynamic external fixator has many advantages over other modalities of treatment with promising results. It gives life to varus arthritic knees in younger individuals.