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KMID : 0361620120470020104
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Journal of the Korean Orthopaedic Association
2012 Volume.47 No. 2 p.104 ~ p.110
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Comparison of Closing-Wedge and Opening-Wedge High Tibial Osteotomies
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Cho Se-Hyun
Hwang Sun-Chul
Sohn Kang-Min
Kim Hyung-Kan
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Abstract
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Purpose: The aim of this study is to compare the clinical results and radiologic changes of closing-wedge high tibial osteotomy (CWHTO) and opening-wedge high tibial osteotomy (OW HTO).
Materials and Methods : Seventy fi ve knees were treated with a CW HTO and 41 with an OW HTO. For each patient the hip-kneeankle (H-K-A) axis was evaluated and the degree of the medial compartmental arthrosis was measured by Ahlback-type radiological classifi cation. The function of the knee was evaluated by the Tegner activity score, the Lysholm knee scoring scale and the Western Ontario and McMaster University index. Lateral radiographs were taken to assess the patellar height and the posterior tibial
inclination.
Results: In both groups signifi cant improvement of the visual analogue scale and range of motion was achieved. The frontal plane H-K-A axis was corrected signifi cantly from varus to the range of physiological valgus and the arthrosis of the medial compartment of the knee progressed gradually. The body mass index was signifi cantly infl uential to the progression of arthrosis. The functions of the knee were improved signifi cantly in all cases. In the closing-wedge group, the patella height was increased at the postoperative period, while it was decreased in the opening-wedge group. There was a tendency of a decrease of the tibial inclination in the CW HTO group and a statistically signifi cant increase of the tibial inclination in the OW HTO group. Recurrence of varus occurred in sixteen cases.
Conclusion: In both groups, improvement of the function of the knee was achieved, but there was no statistical difference. However, the opposite result was found in the patella height and the tibial inclination.
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KEYWORD
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high tibial osteotomy, closing-wedge high tibial osteotomy, opening-wedge high tibial osteotomy, compare
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