J Korean Orthop Assoc.  2023 Jun;58(3):185-195. 10.4055/jkoa.2023.58.3.185 .

Comparison of the Advantages, Disadvantages, Clinical, and Radiological Results of Open Wedge and Closed Wedge High Tibial Osteotomy

• Kim JG
• Park HJ
• Nha KW

• KMID: 2543266
• DOI: http://doi.org/10.4055/jkoa.2023.58.3.185

Abstract

Several studies have reported good results after high tibial osteotomy (HTO) for medial compartment osteoarthritis with varus deformity. Representatively, closed wedge and open wedge HTOs have been performed, and each surgery has its advantages and disadvantages. The closed wedge HTO technique is more difficult, requires bone resection, and the correction angle cannot be recalibrated during the operation. It cannot be used if the correction angle is large, and is difficult to convert to total knee arthroplasty later. But it is advantageous for bone union due to the large bone contact area, early weight bearing, and lower correction loss after the operation. On the other hand, the open wedge HTO has a risk of correction loss, a possibility of non-union or delayed union and can affect the patellofemoral joint. However, the correction angle can be recalibrated during the operation, and it is relatively easy to convert to total knee arthroplasty later. In reviewing the results of the operations, radiologically an increase in leg length, a decrease in patellar height, and an increase in the proximal tibial posterior slope after open wedge HTO are observed. However, there are no significant differences in the long-term survival or clinical results between the two techniques.

Keyword

knee; osteoarthritis; tibia; osteotomy