Open-Wedge High Tibial Osteotomy in Varus Knee Osteoarthritis: A 5-Year Prospective Cohort Study
Buntoeng Pongsoipetch MD*, Chaichana Tantikul MD*
Affiliation : * Orthopaedic Division, Charoenkrung-Pracharak Hospital, Bangkok, Thailand
Background : High tibial osteotomy (HTO) is an accepted procedure to correct the varus deformity to restore
the mechanical axis, reduce pain and delay the need for arthroplasty, especially in young and active patients.
Nowadays, the opening wedge HTO is preferable than the close one.
Objective : To evaluate the clinical results and complications of medial compartment gonarthrosis treated
with opening wedge HTO.
Material and Method: The prospective cohort study of 45 knees in 40 consecutive patients (32 women, 8 men,
46-81 years) with medial compartment osteoarthritis of the knee underwent medial open-wedge HTO and
TomoFixTM between February 2004 and February 2009 (average follow-up of 46.1 + 11.5 months).
Results : During the follow-up period, patients experienced significantly greater pain relief from baseline
pain-intensity scores (all p < 0.001). The mean femorotibial angle (FTA) at the preoperative, 1-year and more
than 2-year follow-up were 171.27 + 9.41 degrees of varus, 182.91 + 4.93 and 182.45 + 5.74 degrees of
valgus, in orderly.
Conclusion : Medial opening wedge HTO with TomoFixTM provided intraoperative desirable correction and
sufficient stabilization. Early mobilization, rehabilitation and maintenance of correction alignment until
bony union occurred without instrument failure.
Keywords : High tibial osteotomy, Open-wedge osteotomy, Varus knee, Medial unicompartmental osteoarthritis
