Comparison of lateral closing and medial opening-wedge technique for high tibial osteotomy in varus knee

Abstract

Objective To compare the surgical methods and clinical results of two kinds of high tibial osteotomy in varus knee. Methods A retrospective analysis was preformed on 68 cases with knee varus who underwent high tibial osteotomy, including 37 cases with closing wedge high tibial osteotomy (CWO) and 31 cases with opening wedge high tibial osteotomy (OWO). Tibial slope was measured using post-operative X-ray film and HSS and Lysholm scores were evaluated. Results All patient were followed up for more than 24 months. There were no statistical differences in pre- and postoperative HSS and Lysholm scores between groups, respectively. 1) The pre- and postoperative tibial slope in the CWO were 8.57°±1.63° and 5.03°±1.24°, respectively, and in the OWO group were 8.71°±1.66° and 10.10°±1.30°, respectively, and sta-tistical difference was found within each group. 2) The pre- and postoperative Insall-Salvati index in the CWO were 0.880±0.053 and 0.820±0.049, respectively, with statistical difference; and in the OWO group were 0.892±0.043 and 0.897±0.042, respectively, without statistical difference. Blackbume-Peel index was 0.804±0.040 preoperative and 0.801±0.339 postoperatively in CWO, without statistical difference; 0.815± 0.039 preoperatively and 0.766±0.037 postoperatively in the OWO, with statistical difference. 3) Postopera-tively all patients showed knee valgus. The valgus angle was 8.65°±1.46° in the OWO and 8.06°±2.75° in CWO. Conclusion There was similar clinical results for both osteotomy techniques, with a more accurate angle in the OWO. Tibial slope decreasing and patellar tendon shortening were observed after CWO, however, OWO can cause the increase of tibial slope and the decrease between the patella and tibiofemoral joint line. Key words: Osteoarthritis, knee; Osteotomy; Tibia