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ABSTRACT: High tibial osteotomy (HTO) has been advocated for the treatment of isolated medial compartment osteoarthritis of the knee. Debate remains over the superiority of performing a medial opening-wedge or lateral closing-wedge HTO. The purpose of this study was to compare the clinical and radiological outcomes, and complications of patients following opening-wedge compared to closing-wedge HTO. A systematic review was undertaken of published and unpublished literature databases from their inception to May 2010. Twelve papers reporting nine clinical trials were found to be suitable for meta-analysis comparing 324 opening-wedge HTOs to 318 closing-wedge HTOs. There was no difference in the incidence of infection, deep vein thrombosis, peroneal nerve palsy, non-union or revision to knee arthroplasty (p>0.05). There was however a significantly greater posterior tibial slope and mean angle of correction, reduced patellar height and hip-knee-ankle angle following opening-wedge HTO (p<0.05). No significant difference was found for any clinical outcome including pain, functional score or complications (p>0.05).
The Knee 10/2010; 18(6):361-8. · 2.01 Impact Factor