Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Dec 18, 2020; 11(12): 606-614
Published online Dec 18, 2020. doi: 10.5312/wjo.v11.i12.606
Impact of medial open-wedge high tibial osteotomy for medial compartment osteoarthritis of the knee
Sunil Sheshrao Nikose, Devashree Nikose, Aditya L Kekatpure, Shashank Jain, Kiran Saoji, Sridhar M Reddy
Sunil Sheshrao Nikose, Aditya L Kekatpure, Shashank Jain, Kiran Saoji, Sridhar M Reddy, Department of Orthopedic and Trauma Surgery, Jawaharlal Nehru Medical College, Wardha 442001, Maharashtra, India
Devashree Nikose, General Doctor, NKP Salve Institute of Medical Sciences, Nagpur 440019, Maharashtra, India
Author contributions: Nikose SS performed all osteotomies, participated in conceptualization, methodology, software, reviewing, editing, and supervision; Nikose D performed data curation, writing, original draft preparation, and formal analysis; Kekatpure AL provided supervision; Jain S participated in visualization and investigation; Saoji K provided software, validation, resources, project administration; Reddy SM wrote, reviewed and edited the manuscript; all the authors contributed to the process of concept, design, acquisition of data and/or analysis and interpretation of data; all the authors drafted the article and/or revised it critically for important intellectual content; all the authors approved the version to be published as per uniform requirements for manuscripts submitted to biomedical journals.
Institutional review board statement: All procedures performed in this study were in accordance with the ethical standards of the committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards and were approved by the Datta Meghe Institute of Medical Sciences, Wardha, India (dated 30 May 2015).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: The data used to support the findings of this study are available on reasonable request from the corresponding author. The data are not publicly available due to information that might compromise the privacy of the research participants (patients).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sunil Sheshrao Nikose, MBBS, MS, Director SVL and Professor, Department of Orthopedic and Trauma Surgery, Jawaharlal Nehru Medical College, Sawangi, Wardha 442001, Maharashtra, India. sunilnikose@gmail.com
Received: June 24, 2020
Peer-review started: June 24, 2020
First decision: August 22, 2020
Revised: August 31, 2020
Accepted: October 23, 2020
Article in press: October 23, 2020
Published online: December 18, 2020
ARTICLE HIGHLIGHTS
Research background

Osteoarthritis (OA) of the knee joint continues to affect humans throughout the world and the general consensus is to treat it either non-operatively or by total knee arthroplasty (TKA) which has acceptable results but causes bone loss and the procedure cannot be undone. This review focused on the points which preserve the bone, cause pain relief due to mechanical alignment of the lower limb, and can provide good long-term outcomes in most populations.

Research motivation

Keeping the research background in mind an anatomical, physiological and biological management was sought to preserve the natural bone of the patient and at the same time reduce functional disability.

Research objectives

High tibial osteotomy (HTO) is common in orthopedic surgery and various techniques have been described, each claiming advantages over the other. However, we aim for precise patient selection, indications, procedures, and acceptable results along with a brief summary of already described surgical techniques, methods of fixation, and complications. This article focuses on the points that should be considered to achieve good long-term outcomes.

Research methods

Prospective clinical study: Level of evidence - Level II.

Research results

Very little data exists on the use of different pharmacological and non-pharmacological treatments for OA. These highly relevant research results are encouraging in terms of good outcomes, less morbidity, less economically disturbing for paying populations and good long-term results as there is a high incidence of comorbidities in this population. OA may be one of many health problems affecting function, and this may influence the appropriateness of management options.

Research conclusions

The goals of treatment for knee OA must include lasting relief of pain and inflammation, and improvement in or maintenance of mobility, function (including activities of daily living and improved health-related quality of life). The efficacy of TKA for improving pain and function has been demonstrated; however, not all patients are candidates for this surgery and it is not suited to the lifestyle of populations who squat and sit cross-legged. Additionally, the HTO provides an effective treatment approach that can relieve pain and improve function to delay or avoid TKA surgery.

Research perspectives

Future directions in knee OA point to more joint preservation techniques and protocols as compared to bone sacrificing extensive surgeries.