Comparative Study Between Medial Opening Wedge High Tibial Osteotomy Using Puddu Plate With or Without Bone Graft “Systematic Review/Meta-Analysis”

Abstract

Medial opening wedge high tibial osteotomy (MOWHTO) is a good choice to manage patients with symptomatic medial compartment arthritis and varus malalignment. Biomechanical data suggest that a biplanar osteotomy and the use of a plate fixator are perfect technique (1). To correctly perform a medial HTO, knowledge of the functional surgical anatomy of the knee and the popliteal region are essential. Important structures within these anatomical regions are related to the osteotomy planes and there are potential risk at the different surgical steps (2). Anatomy: The knee joint is formed by three bones. The femur meets the tibia to form the main weight bearing part of the knee. The patella is located at the front of the knee and acts as a fulcrum to give the thigh muscles a mechanical advantage in straightening the knee (3). These three bones are covered by cartilage, a white highly polished surface that allows frictionless motion of each bone against another. Cartilage coats the end of the femur, the top part of the tibia and behind the patella. Osteoarthritis (OA) occurs when this surface cartilage wears out (3).