Acute correction of adolescent tibia vara with biplanar medial opening wedge osteotomy without a graft

Abstract

Background: This study evaluated the use of biplanar medial opening wedge high tibial osteotomy for correction of adolescent tibia vara. This technique is used successfully in correction of genu varum deformity associated with degenerative knee osteoarthritis. Methods: Twenty-two patients with adolescent tibia vara underwent medial opening wedge high tibial osteotomy without bone grafting. Eight patients had bilateral tibia vara. Twelve were boys and 10 were girls. Radiographs were obtained preoperatively and the mechanical tibiofemoral angle (mTFA), mechanical lateral distal femoral angle (mLDFA) and mechanical medial proximal tibial angle (mMPTA) were measured before and after correction. Results: All osteotomies healed within 10 wk. The mTFA was corrected from an average of 13.6 degrees (9-23 degrees) to within 2.6 degrees from normal mechanical tibiofemoral alignment. The mMPTA was corrected from an average of 76.7 degrees (68-81 degrees) to an average of 88 degrees (86-91 degrees) postoperatively. No neurovascular complications or wound infection occurred. There was only one recurrence that required an additional osteotomy leading to a satisfactory result. Conclusions: Medial opening wedge high tibial osteotomy without a bone graft is a simple, reproducible method for correction of mild to moderate adolescent tibia vara.