Medial degenerative disease of the knee without radiographic osteoarthritis is a good indication for medial open wedge high tibial osteotomy.

Introduction: Medial open wedge high tibial osteotomy (MOWHTO) is a well-established surgical procedure for osteoarthritis (OA) of the knee with varus malalignment. However, it is uncertain whether MOWHTO is an effective surgical procedure for early OA. This study aimed to evaluate the clinical results of MOWHTO for early OA of the knee with varus malalignment.
Materials and Methods: This was a retrospective analysis of 87 patients in whom varus malalignment was corrected by MOWHTO between January 2017 and December 2022. Kellgren-Lawrence grade 0-1 was defined as early OA and grade ≥ 2 as established OA. Range of motion at the knee, Forgotten Joint Score-12, Knee Injury and Osteoarthritis Outcome Score, and radiological findings were compared between the early OA group and the established OA group.
Results: The established OA group (n = 49) was significantly older than the early OA group (n = 38) (p = 0.02). There were no differences between the groups in preoperative or postoperative hip-knee-ankle angle or range of motion or in improvements in the Forgotten Joint Score-12 or Knee Injury and Osteoarthritis Outcome Score. The median follow-up duration was more than 24.0 months in both groups.
Conclusion: MOWHTO had a good clinical outcome in patients with early OA and varus malalignment over a median follow-up of 2 years.
Level of Evidence: III, retrospective study.
Competing Interests: Declarations. Conflict of interest: The authors declare no potential conflicts of interest regarding the research, authorship, or publication of this article. Ethical approval: This study was approved by the Institutional Ethics Committee of Tokyo Women’s Medical University (approval number: 4578) and was conducted in accordance with the Declaration of Helsinki. Informed consent: Informed consent was obtained via an opt-out procedure.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)