This study aims to compare the efficacy, accuracy, and functional outcomes of two different surgical stabilization techniques for medial opening wedge high tibial osteotomy (HTO) in patients with varus deformity and medial compartment osteoarthritis. Patients will be prospectively randomized into two groups: Group 1 (Plate Fixation) will receive acute (single-stage) correction and stabilization with a medial HTO locking plate. Group 2 (HTO External Fixator) will receive stabilization using a self-adjusting HTO external fixator, followed by gradual correction (hemicallotasis/distraction) starting 7 days post-operatively. The study will evaluate radiological correction, functional improvement (using the Oxford Knee Score), and complication rates over a 12-month follow-up period.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
28
Medial Opening Wedge High Tibial Osteotomy.
Medial Opening Wedge High Tibial Osteotomy.
Ataturk University, Department of Orthopedics and Traumatology
Erzurum, Erzurum, Turkey (Türkiye)
Change in Radiological Correction (Hip-Knee-Ankle Angle - HKA)
ssessment of the mechanical axis on full-length weight-bearing radiographs (Measured in degrees).
Time frame: Baseline (Preoperative), 6 Weeks, 3 Months, 6 Months, and 12 Months Postoperative.
Change in Functional Status (Oxford Knee Score - OKS)
Patient-reported functional score assessing pain and knee function.
Time frame: Baseline (Preoperative), 6 Weeks, 3 Months, 6 Months, and 12 Months Postoperative.
Change in Pain Intensity (Visual Analogue Scale - VAS)
Patient-reported pain score from 0 (no pain) to 10 (intolerable pain).
Time frame: Baseline (Preoperative), 6 Weeks, 3 Months, 6 Months, and 12 Months Postoperative
Change in Femoro-Tibial Angle (FTA)
Change in the anatomical axis measured in degrees.
Time frame: Baseline (Preoperative) and 12 Months Postoperative.
Change in Mechanical Axis Percentage (MA%)
Change in the position of the weight-bearing line on the tibial plateau.
Time frame: Baseline (Preoperative) and 12 Months Postoperative.
Change in Posterior Tibial Slope (PTE)
Change in the tibial slope measured in degrees.
Time frame: Baseline (Preoperative) and 12 Months Postoperative.
Change in Patellar Height (Insall-Salvati Index)
Change in patellar height measured by the Insall-Salvati ratio.
Time frame: Baseline (Preoperative) and 12 Months Postoperative.
Incidence of Complications
Incidence of adverse events including pin tract infection (especially Group 2), superficial or deep infection, non-union/delayed union, lateral cortex fracture, hardware exposure, or knee stiffness.
Time frame: Up to 12 months postoperative.
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