Opening wedge high tibial osteotomy using a monoaxial dynamic external fixator

Area of Science:

• Orthopedic surgery
• Biomechanical engineering
• Osteoarthritis treatment

Background:

• Medial knee osteoarthritis significantly impacts patient quality of life.
• High tibial osteotomy is a common surgical intervention for knee osteoarthritis.
• External fixators offer potential advantages in managing osteotomy procedures.

Purpose of the Study:

• To prospectively evaluate midterm outcomes of opening wedge high tibial osteotomy (OW-HTO).
• To assess the efficacy of a monoaxial dynamic external fixator (MDEF) in OW-HTO for medial knee osteoarthritis.

Main Methods:

• Prospective study involving 37 patients (41 knees) undergoing OW-HTO with MDEF.
• Clinical and subjective assessments using IKDC, KOOS, and KSS.
• Radiographic evaluation including long-standing alignment views.

Main Results:

• Mean follow-up of 7 years with 36 patients (40 knees) evaluated.
• Statistically significant improvements in KOOS and IKDC scores.
• Good maintenance of achieved correction with minor loss in some cases; 25% experienced minor pin tract infections.

Conclusions:

• MDEF for OW-HTO demonstrates satisfactory midterm outcomes for medial knee osteoarthritis.
• The technique generally maintains correction, with few severe complications.
• Total knee replacement was necessary for three patients due to persistent issues.