Abstract
Few clinical studies have compared uniplane high tibial osteotomy (HTO) with biplane
HTO. The study aim was to compare the radiological and clinical results of uniplane
HTO and biplane HTO, especially in terms of the increase in the posterior tibial slope
(PTS). Medial opening-wedge HTO patients' medical records and radiological results
from a single institution were retrospectively reviewed. Pre- and postoperative serial
radiographs, including the Rosenberg, lateral view, and standing anteroposterior view
of the whole lower extremity, magnetic resonance imaging at postoperative day 2, and
the Western Ontario and McMaster Universities Arthritis Index (WOMAC) score at postoperative
2 years were reviewed to evaluate radiological and clinical results, including the
change in PTS. A total of 61 knees, including 34 for uniplane and 27 for biplane HTOs,
were enrolled. There were no significant differences in the pre- and postoperative
mechanical angles or incidences of the lateral hinge fractures, and all patients showed
complete union at postoperative 2 years. The PTS was increased more in the biplane
group than in the uniplane group (3.1 ± 2.6 in biplane vs. 0.8 ± 1.7 in uniplane,
p < 0.05). The WOMAC scores were 72 ± 9.3 in the uniplane and 75 ± 5.8 in the biplane
group (not significant). The increase in PTS was lower in uniplane medial opening
HTO than in biplane HTO.
Keywords
medial compartment osteoarthritis - high tibial osteotomy - uniplane osteotomy - biplane
osteotomy - posterior tibial slope
