Comparison of the Results of Geno Varum Surgery by Open and Closed-Wedge, High Tibial Osteotomies

Abstract

Background and Objectives: knee deformities associated with osteoarthrosis (OA) is a common presenting complaint in the orthopedic clinics. High tibial osteotomy (HTO) is an accepted procedure in the treatment of medial knee osteoarthritis with varus deformity. The methods for HTO include boths; open wedge osteotomy and closed wedge osteotomy. In this study compared the results of HTO with these two methods. Materials and Methods: In a descriptive study, 32 patients with genu varus deformity (42 knee) were included. Patients were divided in two age and sex matched groups and treated with open wedge osteotomy or closed wedge osteotomy. Patients in both groups were followed for six month and the results of treatments were compared. Results: 32 patients with genu varus deformity (10 cases (31.2%) bilateral) including 25(78.2%) women and 7(21.8%) men were studied. Incidence of main complication after open wedge and closed wedge osteotomy were similarly (12.5%). The main complication in open wedge was intraarticular fracture and in closed wedge was peroneal nerve Paralysis. There were significant difference in operation time, time of weight bearing and return to daily activities between two groups (p<0.001). The varus correction angle, the Lysholm and the Tegner Activity score and Insall Salvati Index were not significanty different between two groups. Overall patient’s satisfaction in open wedge surgery was 87.5% and in closed wedge was 75%. Conclusion: Results of this study revealed that clinical outcome of patients in open and closed wedged surgery were not different and both methods are successful. However open wedge osteotomy has less neurological complications and higher patient’s satisfaction.