Closing-wedge (CWO) and opening-wedge osteotomy (OWO) resulted in similar functional outcomes, but OWO exhibits greater accuracy for achieving the planned correction angle, evident from the results of a study published in The Journal of Knee Surgery.

The scientists at third Hospital of Hebei Medical University and Bethune International Peace Hospital evaluated the role of closing-wedge and opening-wedge osteotomy in the management of knee arthritis with varus deformity. The closing-wedge osteotomy (CWO) was used for severe lateral tibiofemoral arthritis and opening-wedge osteotomy (OWO) for severe patellofemoral arthritis and patella infera.

A total of seventy-nine patients who went through high tibial osteotomy (HTO) from 2002 to 2008 were assessed for tibiofeomoral angle, lateral and medial tibiofemoral joint space, patellar height and posterior tibial slope via pre- and postoperative radiography and computed tomography. The Kellgren-Lawrence grading system used to measure pre- and postoperative arthritis severity and Lysholm Knee Score (LKS) along with American Knee Society (AKS) score used to measure functional outcomes. Patients were followed up for about 86.1 ± 6.2 months.

At most recent follow-up after CWO and OWO a slight increase in the size of medial tibiofemoral joint space. This demonstrated a notable improvement in AKS knee and function scores and LKS due to a reduction in stress on the medial compartment. Further, the CWO was known to reduce, and OWO increased posterior tibial slope compared to preoperative value. Both approaches exhibited similar functional outcomes for HTO. Depending upon the severity both CWO and OWO could be used in the Anteromedial Unicompartmental Knee Osteoarthritis management.