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Open-Wedge High Tibial Osteotomy with a Slight Valgus Correction From Neutral Limb Alignment Achieves Clinical Improvements Comparable with Those for Knees with Varus Deformity

Open-Wedge High Tibial Osteotomy with a Slight Valgus Correction From Neutral Limb Alignment Achieves Clinical Improvements Comparable with Those for Knees with Varus Deformity

Junya Itou, MD, PhD, JAPAN Umit Kuwa, MD, PhD, JAPAN Masafumi Itoh, MD, PhD, JAPAN Takehiro Shimizu, MD, JAPAN Ken Okazaki, MD, PhD, JAPAN

Tokyo women's medical university, Shinjuku, Tokyo, JAPAN


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Summary: The short-term clinical results of HTO for neutral alignment were as favorable as those for varus malalignment.


Introduction

The effect of high tibial osteotomy (HTO) on the preoperative neutral alignment of the knee is unknown. The purpose of this study was to clarify the clinical outcome of HTO with neutral alignment, defined as within 4 degrees of varus.

Methods

This retrospective study included 146 knees with varus that underwent HTO. The knees were divided according to the preoperative hip-knee-ankle angle into a neutral alignment group (= 4° of varus alignment) and a varus alignment group (> 4° of varus alignment). The Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Forgotten Joint Score-12 (FJS-12) were evaluated preoperatively and at the latest follow-up.

Results

There were no significant differences between the preoperative and postoperative FJS-12 or KOOS subscale scores in the neutral alignment group or the varus alignment group. Each group had a mean change in the KOOS subscale scores that exceeded the minimum clinically important difference.

Conclusion

The short-term clinical results of HTO for neutral alignment were as favorable as those for varus malalignment.


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