High tibial valgus osteotomy using the Tomofix plate--medium-term results in young patients.

Proximal tibial valgus osteotomy is one of the treatment options for painful medial compartment osteoarthrosis and varus deformity of the knee in a young patient. We report our experience with medial opening wedge tibial osteotomy using the Tomofix plate in 46 patients (50 knees). The mean age was 39.5 years (range 30-49). All were male. Mean duration of follow-up was 60 months (36-72 months). There were no non-unions of the osteotomy site and the medial open-wedge healed without any need for bone graft or bone substitutes. There was functional improvement, as seen from the Oxford and Knee Society scores. Preoperative average knee flexion was 110 degrees (range, 90 - 125 degrees) which remained unchanged. The mean preoperative tibio-femoral angle (mechanical) was 7 degrees varus (range, 5-10 degrees); the postoperative angle was 6 degrees valgus (range 5 degrees-8 degrees). One knee was revised to total knee replacement after two years and was considered a failure. The Tomofix plate provided immediate stability, satisfactory healing of the osteotomy site without the need for bone graft or bone substitutes, and good functional results in young patients with isolated medial compartment degenerative disease.