A critical appraisal of medial open wedge high tibial osteotomy for knee osteoarthritis

Abstract

A medial open wedge high tibial osteotomy (MOWHTO) is an effective surgical procedure to correct varus deformity related to Knee Osteoarthritis. It consistently provides relief in knee pain and improves knee function. This technique is recommended for active, middle and old aged individuals with an isolated medial compartment knee OA. The MOWHTO scores several advantages over lateral closed wedge osteotomy and hence is now a preferred choice of HTO.

Defining clinically significant outcomes following high tibial osteotomy with or without concomitant procedures

“…29 For this reason, determination of CSOs following orthopaedic procedures is essential to evaluate the significance of results using PROs. Collins et al previously determined the threshold values for MCID for IKDC (11.5) and KOOS subscales (range, [5][6][7][8][9][10][11][12] in the treatment for various pathologies of the knee. 30 Furthermore, a study of 98 patients by Liu et al reported the MCID and PASS for IKDC (9.9 and 36.0, respectively) and the KOOS subscales (range, 9.5-14.6 and 53.0-73.0, respectively) in patients undergoing meniscal allograft transplantation.…”

“…4 High tibial osteotomy (HTO) represents a viable treatment option for younger patients with medial compartment overload, improving function and reducing pain while slowing OA progression. [3][4][5][6] Successful HTO may delay the need for arthroplasty in patients by approximately a decade. [7][8][9][10] Appropriate patient selection is critical, with HTO indicated primarily in young (age < 50), active, non-obese patients with unicompartmental disease without ligament instability or severe deformities (> 20 degrees).…”

Bilateral genu varum deformity correction in an adult by medial opening-wedge high tibial osteotomy without internal fixation

“…Various operative techniques are described and used for the HTO; the most popular being an opening wedge osteotomy 4 5. The medial open wedge osteotomy (MOWHTO) offers several advantages like restoring the height of the medial column, not significantly altering the tibial slope and patellar height, easy to convert to TKA, no fibular osteotomy required, and no restriction of activities needed,6 7 as with arthroplasty. A MOWHTO is mostly fixed with different types of commercially available plates.…”

Cartilage regeneration techniques with concomitant high tibial osteotomy (HTO), An innovative biomechanical therapy for osteoarthritis (OA) knee – Systematic review

“…Treatment of unicompartmental (UC) knee osteoarthritis among young, active patients represents a substantial challenge for orthopaedic doctors. [1][2][3] Total and UC knee replacements deliver excellent relief in discomfort like pain and results for elderly persons, but the risks of executing arthroplasty procedures on younger, more active patients are greater because they have a greater chances of prosthesis wear and may therefore require one or more revised processes with greater morbidity. For younger, more active persons with isolated medial compartment osteoarthritis, a long-term alternative to joint replacement is High Tibial Osteotomy (HTO).…”