Comparison of closing-wedge and opening-wedge high tibial osteotomies for medial compartment osteoarthritis of knee in Asian population: Mid-term follow-up |
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| Institution: | 1. P.D. Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg Mahim, Mumbai 400016, India;2. Darlington Memorial Hospital, County Durham & Darlington Foundation Trust, DL3 6HX, United Kingdom;1. Department of Orthopaedics, School of Medicine, Flinders University, Adelaide, Australia;2. International Musculoskeletal Research Institute Inc., Adelaide, South Australia, Australia;3. Department of Orthopaedic Surgery & Trauma, Flinders Medical Centre, Adelaide, South Australia, Australia;4. Flinders Centre for Epidemiology and Biostatistics, School of Medicine, Flinders University, Adelaide, South Australia, Australia;1. Assistant Prof. Orthopedic Surgery, Mansoura University, Faculty of Medicine, Egypt;2. Assistant Prof. Anatomy, Alazhar University, Faculty of Medicine, Egypt;1. Nova Southeastern University, College of Osteopathic Medicine, 3301 College Avenue, Davie, FL 33314, United States;2. OrthoSensor Inc., Department of Clinical Research, 1855 Griffin Road, Dania Beach, FL 33004, United States;3. Holy Cross Hospital, Leone Center for Orthopedic Care, 1000 NE 56th Street, Fort Lauderdale, FL 33334, United States;1. Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan;2. Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan;3. Division of Epidemiology, Center for Devices & Radiological Research, Food and Drug Administration, Silver Spring, Maryland;4. OrthoSynthesis, Inc, San Jose, California;1. Fiona Stanley Hospital Group & Orthopaedics WA, Perth, Australia;2. Curtin University, Perth, Australia;3. University of Sydney, Sydney, Australia;4. Steve Biko Academic Hospital, The University of Pretoria, Pretoria, South Africa;5. Mater Hospital, Sydney, Australia;6. Orthopaedic Department, Western Health, Melbourne, Australia;7. Wagga Private Hospital, Wagga, Australia;8. Westmead Private Hospital, Sydney, Australia;9. The University of Sydney & Northern Local Area Health District (Royal North Shore Hospital), Sydney, Australia;1. Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH;2. Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, TX;3. Instituto Universitario del Hospital Italiano, Buenos Aires, Argentina |
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| Abstract: | BackgroundValgus high tibial osteotomy (HTO) is a well-established treatment option for patients with early osteoarthritis of the medial compartment of the knee. It is achievable with either open-wedge or closed-wedge technique. The aim of the study was to compare the radiological and clinical outcomes following HTO done with open- and closed-wedge techniques.Material and methodsTwo groups of patients undergoing HTO and fixation with locking plates were compared. Twenty-five patients were operated using medial open-wedge technique and 23 using closed-wedge technique between January 2000 and June 2014. They were compared on the basis of Hospital for Special Surgery (HSS), knee score, preoperative and postoperative range of motion, femoro-tibial angle and duration required for full-weight bearing. Early and late postoperative complications were noted.ResultsMedian HSS score at 6 months and 1 year post-surgery was better in the open-wedge technique group. The range of motion was also higher at early follow-up in the open-wedge technique group, with shorter duration for full-weight bearing. Delayed union was seen in two patients in the open-wedge technique group and four patients in closed-wedge group. Peroneal nerve palsy was noted in two patients in the closed-wedge group.ConclusionBoth open-wedge and closed-wedge HTO lead to good and comparable results. However, the technique of open-wedge osteotomy provided better outcome in terms of functional scores in early as well as late follow-up with decreased duration required for full-weight bearing. |
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| Keywords: | High tibial osteotomy Medial opening-wedge osteotomy Lateral closing-wedge osteotomy MOWHTO CWHTO |
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