Summary

Both techniques are good for performing a HTO, but it is important to remain vigilant, specially in the OW-HTO, to avoid unwanted changes in the patellar height.

Abstract

Purpose

The two most commonly used techniques for performing a knee valgus osteotomy are the opening wedge high tibial osteotomy (OW-HTO) and the closing wedge high tibial osteotomy (CW-HTO). The objective of this study was to compare the patellar height between these two surgical procedures.

Methods

This is a retrospective cohort study. All OW-HTO and CW-HTO procedures operated on between 2018 and 2020 in our institution were included. We analysed their functional outcomes (KOOS-12, Tegner activity scale, pain and satisfaction) and radiological outcomes (HKA, MPTA, tibial slope and patellar height).

Results

Fifty-one patients met the inclusion criteria (27 OW-HTO and 24 CW-HTO). Our study did not find any difference in patellar height following CW-HTO, however, statistically significant differences were observed after OW-HTO, where the mean Caton Deschamps Index decreased 0.17 points (p<0.001).
Good to excellent functional outcomes, significant pain reduction (>6 points) and high patient satisfaction where found (>9/10) in both groups. Both techniques yielded excellent radiological outcomes in coronal plane alignment.

Conclusion

Both techniques are good option for performing a HTO, but it is important to remain vigilant when performing these techniques, specially the OW-HTO, to avoid unwanted changes in the patellar height.