Functional outcome of open-wedge high tibial osteotomy in medial compartmental osteoarthritis of knee joint

Abstract

Introduction: Due to the shifting of weight more on the medial side of the knee, more cartilage destruction occurs medially, and subsequently, varus deformity occurs. A corrective osteotomy to alter the weight-bearing axis will be ideal to slow down the degenerative process. The success of an osteotomy around the knee depends on the biomechanics of the lower extremity, load distribution in the knee, and also on the mechanical properties of the implants used for osteotomy fixation. The aim of the study is to know the functional outcome of open-wedge high tibial osteotomy in medial compartmental osteoarthritis of the knee joint. Materials and Methods: This prospective study was done at the tertiary center of Bihar between May 2016 and September 2018. Bilateral weight-bearing anteroposterior view in full extension and standing scannogram was taken preoperatively. Patients were operated and evaluated at 3, 6, and 12 months by the Japanese Orthopaedic association knee score and Japanese Orthopaedic association system. Results: Medial opening-wedge osteotomy was performed in 26 knees of 24 in which there were 10 male and 14 female patients. Of the 26 knees operated, 16 were of the left side and 10 of the right side. Of the 26 knees operated, 6 (23%) had excellent outcome, 12 (47%) had good outcome, 4 (15%) had fair, and 4 (15%) had poor outcome. The poor result of three patients was correlated to superficial infection and the other patients due to inadequate correction. Five patients had superficial infection and one patient had hardware prominence causing pain and two patients had under correction of varus. Conclusion: From this prospective study, it can be concluded that medial open-wedge high tibial osteotomy is a useful option in medial compartmental osteoarthritis of the knee joint and relieves pain and improves functional outcomes in patients.