• Simo S A Miettinen, MiettinenHannu J AHJADepartment of Orthopaedics, Traumatology, and Hand Surgery, Kuopio University Hospital, P.O. Box 1777, 70211, Kuopio, Finland., Jussi Jalkanen, Antti Joukainen, and Heikki Kröger.
• Department of Orthopaedics, Traumatology, and Hand Surgery, Kuopio University Hospital, P.O. Box 1777, 70211, Kuopio, Finland. simo.miettinen@kuh.fi.
• Arch Orthop Trauma Surg. 2022 Nov 1; 142 (11): 3111-3121.

IntroductionThis retrospective study investigated the long-term follow-up results of medial opening wedge high tibial osteotomy (MOWHTO) with a pre-countered non-locking steel plate implant (Puddu plate = PP) used for medial knee osteoarthrosis (OA) treatment.Materials And MethodsConsecutive 70 MOWHTOs (66 patients) were performed between 01.01.2004 and 31.12.2008 with the mean follow-up time of 11.4 (SD 4.5; range 1.2-16.1) years. The Kaplan-Meier survival analysis was used to evaluate the cumulative survival of the implant in terms of age (< 50 years old and ≥ 50 years old) and gender. Adverse events were studied and Cox regression analysis was used to evaluate risk factors [age, gender, body mass index (BMI), preoperative mechanical axis, severity of OA, use of bone grafting or substitution and undercorrection of mechanical axis from varus to valgus] for revisions.ResultsThe estimates for the cumulative survival with no need for TKA after MOWHTO were 86% at 5 years, 67% at 10 years and 58% at 16.1 years (SE 0.6, CI 95% 11.1-13.5). A total of 33/70 (47%) adverse events occurred and 38/70 (54%) knees required some revision surgery during the follow-up. Cox regression did not show any statistically significant risk factors for revision.ConclusionsThe PP has feasible MOWHTO results with a cumulative survival of 67% at 10 years with no need for conversion to TKA. Many adverse events occurred and revision rate due to any reason was high. Age or gender did not have statistically significant differences in terms of survival.© 2021. The Author(s).

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