High tibial osteotomy for 2–3 stage osteoarthritis as an alternative to knee arthroplasty

Objective. To study the effectiveness of high tibial osteotomy (HTO) in the treatment for 2–3 stage osteoarthritis of the knee.Materials and methods. Over 2015–2022 period, 56 surgeries using HTO were performed in 49 patients with knee osteoarthritis of stages 2–3 at Vladivostok Clinical City Hospital No. 2. Biplanar osteotomy was performed above the tibial tuberosity. Locking compression plates were used for fixation. The results were assessed according to the Lysholm Knee Score and VAS.Results. The follow-up results in 37 patients were monitored up to 5 years. Deformity correction was revealed in each case. The study indicated a persistent reduction in the mean values of the VAS scale from 1.1 to 2.7, as well as a significant improvement in the clinical and functional characteristics of the knee joint according to the Lysholm Knee Score. In 5 years after the procedure, the survival rate comprised 100%.Conclusion. High tibial osteotomy is a complex procedure requiring long-term training and considerable experience of a surgeon, proper assessment of indications, meticulous preoperative planning, and adherence to surgical techniques. The HTO results demonstrate that a long-term delay in knee arthroplasty is feasible.