الفهرس 
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Abstract
Osteoarthritis is the leading cause of musculoskeletal disability worldwide. Knee osteoarthritis presents with a complaint of pain and swell¬ing resulting in decreased joint mobility. It is well known that there are advantages to delay arthroplasty given a higher wear rate and the likelihood for future complex revisions if the primary surgery is performed in patients with young age. For medial compartment degenerative disease, the correction is generally performed through a closing lateral wedge osteotomy or opening medial wedge osteotomy. Osteotomies involving the knee can be performed in a number of ways. The idea of proximal tibial osteotomy is to unload an overloaded compartment, to slow down the progress of osteoarthritis and to allow healing of articular cartilage.
The aim of this work was to evaluate the results of proximal tibial medial open wedge osteotomy with Puddu plate in the treatment of medial compartment osteoarthritis of the knee associated with genu varum.
This was a prospective case series study performed from December 2012 till February 2014. On 19 patients (20 knees) admitted to El-Hadra University Hospital and Alexandria Police Hospital. The age ranged between18-50 years. There was 13 male (68.4%) and 6 females (31.6%). In 11 knees the left side was affected (58%), 8 knees (37%) on the right side and one bilaterally (5%).
There were 4 unsatisfactory results at final follow up (20%) and 16 satisfactory (80%). Excellent results were 3 patients (Lysholm from 100-91; mean 94), Good results were 13 pateints (Lysholm from 90-80; mean 85.4) and poor results were 4 (Lysholm<80; mean 65). The mean time of follow up was 6 months. The size of Puddu plate ranges from 8 to 16 mm with size 14mm and 10mm being the most common used respectively (8 and 7 knees).
We found no difference in early results (6 months) between correction and under-correction of the varus deformity as the both cause unloading of the medial compartment, Lateral cortex violation in proximal tibial osteotomy fixed by Puddu plate gives inferior results and Pes ansirnous fibrosis and inflammation were frequently seen in the proximal tibial osteotomy fixed with Puddu plate and easily treated with local cortisone injection.