Short-term outcome of high tibia osteotomy in unicompartmental medial osteoarthritis of the knee: a single center report

As an established method of treatment for medial unicompartmental knee osteoarthritis, we aimed to evaluate results of short-term follow up of closed and open wedge high tibial osteotomy. In teaching hospital of Rasoul-e-Akram and during 2001-2009, we retrospectively surveyed docu-ments of 41 cases with osteoarthritis of the knee and genu varum deformity that underwent high tibial osteoto-my. Radiographic evaluation of knee alignment was performed using lower extremity scanogram in three measurements of preoperation, postoperation and last follow up visit (average of 2 years). Improvement of pain was assessed via visual scales. From a total of 13 closed and 28 open wedge high tibial osteotomies, the femorotibial angles were calculated varus of 7.7±2.5° preoperatively, valgus of 7±2.3° postoperatively and reached valgus of 6.1±3° at the final follow-up. In open-wedge osteotomies, loss of correction was meaningful during follow-up, mainly in patients without fixation. Higher amount of preoperative knee varus (>10°) was accompanied with more loss of correction postoperatively. About 80% of patients were satisfied of pain relief with average knee flexion of 125 degrees. Our major complications were two cases of intra-articular fracture. Open wedge cases without plate fixation experienced more failure of correction. With proper patient selection and applying appropriate technique plus sufficient correction, high tibial osteotomy can be an effective treatment for medial knee osteoarthritis with genu varum. It may diminish the need for knee arthroplasty or at least delay the surgery.