Iranian Journal of Orthopedic Surgery

Open Wedge Proximal Tibial Osteotomy for Varus Knee: Comparison of MCL Release with MCL Preservation in above or below Tibial Tubercle Osteotomies

Authors

Mahmood Karimi Mobarakeh, MD
Mohsen Mardani-Kivi, MD
Ali Akbar Keikha, MD
Keyvan Hashemi-Motlagh, MD
Khashayar Saheb-Ekhtiari, MD
https://doi.org/10.22034/ijos.2020.121286
Abstract
Background: One of the common operations for lower limb mal-alignment below 50 years of age is proximal tibial osteotomy. In the open wedge technique, the superficial medial collateral ligament (MCL) usually needs to be released.  This study seeks to evaluate the results of open wedge high tibial osteotomy with or without releasing MCL.Methods: In a prospective clinical trial, 59 patients with symptomatic genu varum between 16-50 years of age who were candidates of tibial osteotomy were divided into open wedge surgery with (30 patients, 40 knees) or without MCL release (29 patients, 36 knees). The outcome was studied comparing the stability in valgus, pattelar height slope of tibial plateau, and also the knee score (KSS) in a 17.4 months (3-24 months) follow-up.Results: The patients from MCL preserving group, with mean age of 26.7±9 improved their scores of 53.5±15.2 to 81.9±13.4. The cases from MCL-releasing group with mean age of 25.5±8.4 improved the score of 52.4±14.6 to 65.4+17.8. The rates of surgical complication and valgus instability were lower in MCL preserving ones, but tibial slope remained unchanged in either group.Conclusions: Both techniques lead to an improvement in the KSS score however it was more significant in MCL preserving group with lower complication and without valgus instability.

Keywords

Genu Varum
Osteotomy
Tibia
Open wedge
Ligament
articular

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