OBJECTIVE: Roentgenographic assessment of lower limb alignment, in the frontal and sagittal planes, after a high tibial osteotomy. To stabilize the osteotomy, a tricortical iliac graft was used along with a positioning screw. METHODS: Prospective study of 46 patients with ages ranging from 17 to 61 years. Among them, 42 patients were carriers of genu varum secondary to knee osteoarthritis and four from other causes. Radiography was performed for surgical planning, using the Frank Noyes method modified by Fugizawa. Three cm conventional surgical access was performed to remove a tricortical iliac graft. The osteotomy was performed under fluoroscopic control, by 3 cm anteromedial incision with release of the superficial portion of the medial collateral ligament. The graft was placed in the posterior portion of the osteotomy to maintain an unaltered tibial slope. The screw crossed the osteotomy orthogonally to protect the lateral cortex. Radiographic criteria were established pre-and postoperatively to assess the results. RESULTS: There was consolidation in 100% of cases and maintenance of the mechanical axis, obtained intraoperatively in 94% of cases. Correction of mechanical axis occurred in 94% (43 patients / 47 osteotomies). The posterior slope of the tibial plateau in the sagittal plane ranged from 7º to 12º. Joint mobility was restored in all patients. Eleven patients had temporary pain at the site of graft removal, however, none had paraesthesia. The incidence of complications was 8% (infection, loss of correction, joint fracture). CONCLUSION: This technique is reproducible, simple, biologic, accurate, low-cost, and can be used as an alternative to existing techniques.
Osteotomy; Knee; Osteoarthritis; Tibia
