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. 2016 Dec 1;28(4):270-276.
doi: 10.5792/ksrr.15.075.

Open Wedge High Tibial Osteotomy and Combined Arthroscopic Surgery in Severe Medial Osteoarthritis and Varus Malalignment: Minimum 5-Year Results

Moon-Jib Yoo  1 , Yong-Eun Shin  1
Affiliations

Open Wedge High Tibial Osteotomy and Combined Arthroscopic Surgery in Severe Medial Osteoarthritis and Varus Malalignment: Minimum 5-Year Results

Moon-Jib Yoo et al. Knee Surg Relat Res. .

Abstract

Purpose: To evaluate the radiologic and functional outcomes of medial open wedge high tibial osteotomy (HTO) combined with arthroscopic procedure in patients with medial osteoarthritis.

Materials and methods: From June 1996 to March 2010, 26 patients (32 knees) who underwent medial open wedge osteotomy and arthroscopic operation for medial osteoarthritis were retrospectively reviewed. Measurements included hip-knee-ankle (HKA) angle, femorotibial angle, medial proximal tibial angle, posterior tibial slope angle, and Kellgren-Lawrence grade. Clinical evaluation was performed using Lysholm knee scoring scale and knee and function score of the American Knee Society.

Results: Differences between the mean preoperative and postoperative measurements were significant in all angles including the HKA angle (-5.7° and +5.5°), femorotibial angle (-1.9° and +9.8°), and medial proximal tibial angle (82.9° and 90.5°) (p<0.05). Mean Lysholm knee scoring scale was 63.6 preoperatively and 88.7 at the last follow-up, mean Knee Society knee score was 61.2 and 86.6, and mean function score was 59.3 and 87.2, respectively. All differences were significant (p<0.05).

Conclusions: Medial open wedge HTO in combination with arthroscopic procedure is an effective treatment method for medial osteoarthritis to treat varus deformity and an intra-articular lesion.

Keywords: Arthroscopy; Knee; Osteoarthritis; Osteotomy.

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Figures

Fig. 1
Fig. 1
Safe zone: between A and B. A: tip of fibular head. B: circumference line of the fibular head.
Fig. 2
Fig. 2
Hip-knee-ankle angle (HKAA) measurement method and correction of varus deformity. Note that dash line passes the ‘Fujisawa point’.
Fig. 3
Fig. 3
Femorotibial angle (FTA), medial proximal tibial angle (MPTA), and posterior tibial slope angle (PTSA) measurement methods.
Fig. 4
Fig. 4
(A) Osteochondral defect was detected in arthroscopy and microfracture was performed. (B) Second-look arthroscopic finding at 18 months after surgery: the articular surface was covered with fibrocartilage.
See this image and copyright information in PMC

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