STUDY OF EFFICACY OF HIGH TIBIA MEDIAL OPEN WEDGE OSTEOTOMY IN MEDIAL COMPARTMENT OSTEOARTHRITIS

Abstract

Knee osteoarthritis is a degenerative condition causes progressive wear in the articular cartilage and rises pressure over the medial compartment of the knee joint which will end up as a varus deformity. High tibial osteotomy is one of the surgical managements in treatment knee osteoarthritis, the goal of the treatment is to relieve medial compartment knee pain and slowdown the arthritic progression. The purpose of study to evaluate the efficacy of Medial Opening-Wedge High Tibial Osteotomy for Medial Knee Osteoarthritis. The study is a prospective descriptive clinical study was car-ried out between 2023 and 2023 across two designated specialized surgical centers in the Aden Governorate, Yemen Twenty consecutive active patients (comprising 23 knees) presenting with symptomatic isolated medial compartment knee osteoarthritis Kellgren-Lawrence grades II–III associated with mechanical varus deformity were enrolled , all in-cluded subjects had proven refractory to conservative management protocols for at least three to six months medial open wedge high tibia osteotomy was technically executed via a standard medial approach, the clinical and functional assessment was systematically compiled at baseline (preoperative) and at a final 2-year postoperative follow-up using the validated Arabic translation of the Knee Injury and Osteoarthritis Outcome Score. The definitive study sample con-sisted of 55% male and 45% female patients, with a mean age of 44.55±9.6 years and a well-controlled mean Body Mass Index of 24.80±1.5 kg/m2 , Preoperative radiographic staging classified 60% of cases as Kellgren-Lawrence grade III and 40% as grade II , Lateral distribution demonstrated a right-sided dominance in 60% of cases, followed by 25% left-sided, and 15% presenting with bilateral involvement the intraoperative distraction produced an average oste-otomy wedge gap size ranging between 13 and 14 mm, Functional evaluation was done by comparing pre .and postop-erative scores (knee Injury and osteoarthritis outcome scoring ) ,the final 2-year post-surgical evaluation, all five dis-crete functional domains evaluated via the Knee Injury and Osteoarthritis Outcome Scoring subscales exhibited pro-found, statistically significant improvements relative to the baseline preoperative marks (p<0.001) osteotomy gaps were safely achieved in 100% of the evaluated knees (23/23) within an average healing window of 12 to 24 weeks No instances of structural construct failure, secondary loss of coronal realignment, or non-union were observed. The con-clusions of study was the Medial opening-wedge high tibial osteotomy utilizing rigid plate stabilization without bone grafting constitutes a highly effective, safe, and biologically reliable joint-preserving procedure for active patients un-der 60 years old suffering from mild-to-moderate varus knee osteoarthritis, The procedure delivers outstanding short- to midterm functional recovery, excellent pain relief.