The effects of monoplanar and biplanar medial open wedge high tibial osteotomy on pain and functional capacity.

Abstract

This prospective cross-sectional study aimed to compare the effects of operation types on pain and functional capacity in patients who underwent monoplanar and biplanar medial open wedge high tibial osteotomy. The study included a total of 117 patients who presented at our clinic between January 2012 - January 2016 and underwent monoplanar (n=63) and biplanar (n=54) medial open wedge high tibial osteotomy. The groups were evaluated in age, gender, Body Mass Index (BMI), operation side, operation time, follow-up period, Modified Insall Salvati ratio, Blackburn Peel Index (BPI), Slope, Knee Society Function Score (KSSF), Knee Society Score (KSSK), Visual Analog Scale (VAS), Kellgren Lawrence score, tibiofemoral angle varus, and Tegner score. Most of the patients in the monoplanar group were operated on the right side, while most patients in the biplanar group on the left side, and the difference between the groups was significant (p<0.05). The operation time was significantly longer in the biplanar group, while the duration of follow-up was statistically significantly longer in the monoplanar group (p<0.05). The preoperative BPI and Kellgren Lawrence scores were significantly higher in the monoplar group, while BMI, KSSK, and tibiofemoral angle varus scores were statistically significantly higher in the biplanar group (p<0.05). Postoperative VAS and Kellgren Lawrence scores were higher in the monoplanar group, and the Modified Insall Salvati ratio, BPI, BMI, KSS function score, KSSK score, tibiofemoral angle varus, and Tegner scores were statistically significantly higher in the biplanar group (p<0.05). Postoperatively, the mean VAS score was lower in the biplanar group, and the range of change was greater. In the monoplanar group, the postoperative VAS values were closer to each other and were higher than in the biplanar group. The mean postoperative KSS function score was higher in the biplanar group, and the range of change was higher in the monoplanar group. The study results showed that biplanar medial open wedge high tibial osteotomy was more successful in terms of both pain and functional capacity. However, the operation time was longer than the monoplanar method.