Closed- Versus Open-Wedge High Tibial Osteotomy for Unicompartmental Knee Osteoarthritis .
Opening- and closing-wedge high tibial osteotomy are comparable and early full weight bearing is safe with angular stable plate fixation: a meta-analysis.
Knee Surg Sports Traumatol Arthrosc . 2023 Jul;31(7):3015-3026.10 + 3 randomized controlled trials (314 and 189 patients, respectively) that compared open-wedge high tibial osteotomy versus closed-wedge high tibial osteotomy and early- versus delayed-full-weight bearing (FWB), respectively, in patients with unicompartmental knee osteoarthritis. Outcomes of interest included pain on a Visual Analog Scale (VAS), normalized pain scale and activities of daily living, Hospital for Special Stay (HSS), normalized function scale, posterior tibial slope, and the incidence of conversion to total knee arthroplasty, delayed union, and the International Knee Documentation Committee (IKDC). All outcomes were similar between the two groups except for normalized pain scores and posterior tibial slope changes which favored the closed wedge group. Additionally, in the rehabilitation protocol portion of the study, there were no differences in IKDC scores and delayed union between the early- and delayed FWB groups.
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