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Gait and plantar pressure changes after medial open-wedge high tibial osteotomy combined with arthroscopic partial
Jizhe Lu1, Zhiwei Peng1, Qiang Gu1
1The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
Purpose:
To evaluate the effects of medial open-wedge high tibial osteotomy (MOWHTO) combined with arthroscopic partial meniscectomy (APM) on spatiotemporal gait parameters and plantar pressure distribution in patients with varus knee osteoarthritis (KOA).
Methods:
A prospective study was conducted including 25 patients with medial compartment KOA who underwent MOWHTO combined with APM and 25 healthy controls. Gait parameters and plantar pressure were recorded preoperatively and 4 months postoperatively using the Zebris FDM pressure platform. Radiographic parameters-including the femorotibial angle (FTA), medial proximal tibial angle (MPTA), weight-bearing line ratio (WBLR), and tibial plafond inclination (TPI)-as well as clinical scores (VAS, HSS, WOMAC, and Lysholm) were assessed.
Results:
Postoperative radiographic parameters and clinical scores significantly improved (P < 0.001). Stride length (P < 0.05), gait velocity, and affected-limb stance duration (P < 0.01) increased. COP path length (P < 0.001) and gait temporal symmetry indices (P < 0.01) decreased. Radiographic correction correlated with plantar-pressure variables (P < 0.05). Medial forefoot (M1) and medial heel (HM) contact time and peak pressure also increased (P < 0.05).
Conclusion:
MOWHTO combined with APM was associated with improvements in lower-limb alignment, gait performance, plantar-pressure distribution, and gait symmetry during the short-term postoperative period.