Effect Analysis of Opening Wedge High Tibial Osteotomy (OWHTO) for the Treatment of Medial Compartment Osteoarthritis

Abstract

To investigate the clinical efficacy of open wedge high tibial osteotomy (OWHTO) in the treatment of medial compartment osteoarthritis of the knee.The authors used open OWHTO combined with TomoFix internal fixation to treat 46 cases (52 knees) with knee osteoarthritis with patella varus deformity from 2015.01 to 2017.10. HSS score and VAS score of Knee joint were used to evaluate the improvement of knee function and pain before and after surgery. The femorotibial angle (FTA), medial proximal tibial angle (MPTA), kneecap varus angle (KVA), and Weight-bearing line ratio of lower limbs (WBL) were measured by videography, which can evaluate the correction effect of postoperative knee varus. There were no happenings of internal fixation failure, delayed bone healing or non-union in these follow-up patients. At the follow-up of 3 months, 6 months, and 12 months, the HSS scores of the patients were significantly higher than those before the operation, and the difference was statistically significant (P<0.05). On March, June, and December after surgery, the HSS scores of patients were significantly higher than those before surgery and the difference was statistically significant (P<0.05). The VAS scores were lower than those before surgery, and the difference was statistically significant (P<0.05). These scores had no significant difference in the different follow-up time points (P>0.05). Imaging examination indexes showed that FTA, MPTA, KVA and WBL were improved after surgery and the varus deformity was corrected. Moreover, the difference was statistically significant (P<0.05). These scores had no significant difference in the different follow-up time points (P>0.05). In general, OWHTO can relieve joint pain and improve joint function by correcting lower limb line, showing good effect on medial compartment osteoarthritis of knee joint with varus.