Summary

Tibial Slope increase after opening wedge high tibial osteotomy while no variation in sagintal plante after closing wedge technique.

Abstract

Purpose

High tibial osteotomy (HTO) is a common surgical approach for knee valgus correction, with opening wedge (OW-HTO) and closing wedge (CW-HTO) techniques being widely used. This study aimed to evaluate the difference in tibial slope variation between these two techniques.

Methods

A retrospective cohort study was conducted, including patients who underwent OW-HTO or CW-HTO between 2018 and 2020. Functional outcomes (KOOS-12, Tegner activity scale, pain, and satisfaction) and radiological parameters (HKA, MPTA, tibial slope, and patellar height) were analysed.

Results

Fifty-one patients were included (27 OW-HTO, 24 CW-HTO). Tibial slope remained unchanged following CW-HTO, while OW-HTO resulted in a significant increase in mean tibial slope by 1.5º (p<0.001). Both groups demonstrated good to excellent functional outcomes, substantial pain reduction (>6 points), and high patient satisfaction (>9/10). Radiologically, both techniques achieved excellent coronal plane alignment.

Conclusion

Both techniques are good option for performing a HTO, but it is important to remain vigilant in the sagittal plane when performing these techniques, specially the OW-HTO, to avoid undesired changes in the tibial slope.