JOURNAL OF EVIDENCE BASED MEDICINE AND HEALTHCARE

Table of Contents

2018 Month : July Volume : 5 Issue : 28 Page : 2095-2099

A PROSPECTIVE COMPARATIVE STUDY BETWEEN MEDIAL OPENING WEDGE AND LATERAL CLOSING WEDGE HIGH TIBIAL OSTEOTOMY IN OSTEOARTHRITIS KNEE

Jagat Jyoti Dhara1, Sudip Bhattacharyya2, Anant Kumar Garg3, Sanjay Kumar4, Kiran Kumar Mukhopadhyay5

Corresponding Author:
Dr. Kiran Kumar Mukhopadhyay,
T4/F11/A4, Ruchira Residency,
Kolkata- 700078, West Bengal.
E-mail: orthokiran@gmail.com
DOI: 10.18410/jebmh/2018/434

 

ABSTRACT
BACKGROUND
High Tibial Osteotomy (HTO) is an accepted procedure to correct varus deformity to restore the mechanical axis, reduce pain and delay the need for knee arthroplasty, especially in young and active patients.
The objectives of the study were- 1. to study the difference in results after medial open wedge osteotomy and lateral closing wedge osteotomy and 2. to evaluate the difference in outcome between previous studies of high tibial osteotomy.

MATERIALS AND METHODS
Medial open wedge high tibial osteotomy was performed in 20 knees of 20 patients and lateral closed wedge high tibial osteotomy was performed in 20 knees of 20 patients. The mean age of patients was 55.3 years in medial open wedge group and 52 years in lateral closing wedge group.

RESULTS
All patients had pain relief and improvement after osteotomy. The mean knee score according to Knee Society Score was 41.8±7.9 (pre-op) and 86.8±4.85 (post-op) in medial open wedge osteotomy, 36.6±3.2 (pre-op) and 83.2±9.16 (post-op) in lateral closed wedged osteotomy. The functional knee score was 47±9.48 (pre-op) and improved to 82±6.32 post operatively in medial open wedge osteotomy. The same was 44.5±11.4 and 76±5.1 respectively in lateral closed wedge osteotomy at the time of final follow-up.

CONCLUSION
We found that results of both procedure are same although lateral closed wedge osteotomy is technically demanding. Medial open wedge high tibial osteotomy is simple, with less complication and becoming more and more popular with lots of modifications. Early mobilization, rehabilitation and maintenance of alignment until bony union occurred without implant failure.

KEYWORDS
High tibial osteotomy, medial open-wedge osteotomy, lateral closing wedge osteotomy, medial unicompartmental osteoarthritis, varus knee.