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The accurate preoperative measurement of the tibiofemoral angle,
optimizing valgus correction, and ensure resection in accordance with the
planned valgus angle is essential to improve the long term outcomes.
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.
J Knee Surg
Clinical Outcomes of Closing- and Opening-Wedge High Tibial Osteotomy for Treatment of Anteromedial Unicompartmental Knee Osteoarthritis
Jiangfeng Lu et al.
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