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High tibial closing-wedge, opening-wedge osteotomies produce similar outcomes
No differences in clinical outcomes or radiographic alignment were found between high tibial closing-wedge and opening-wedge osteotomies among patients without conversion to total knee arthroplasty, according to study results.
Researchers randomly assigned 92 patients to receive either a closing-wedge or an opening-wedge high tibial osteotomy and examined clinical outcomes and radiographic results preoperatively and at 1 and 6 years postoperatively. Outcomes included maintenance of the achieved correction, progression of osteoarthritis, severity of pain, knee function, walking distance, complications and survival with conversion to a total knee arthroplasty (TKA) as the end point.
Study results showed the mean hip-knee-ankle (HKA) angle was 3.2° of valgus after a closing-wedge high tibial osteotomy and 1.3° of valgus after an opening-wedge high tibial osteotomy at 6 years postoperatively.
The researchers found no difference between the 6-year and 1-year postoperative HKA angles, and no difference in severity of pain or in knee function between the two groups.
Four complications occurred in the closing-wedge group and 17 in the opening-wedge group, according to the researchers.
Within the 6-year period, 10 patients in the closing-wedge group needed conversion to a TKA compared with three patients in the opening-wedge group.
Disclosure: The authors have no relevant financial disclosures.