A Comparison of the results and prognosis of genovarum correction with open wedge osteotomy and open wedge osteotomy with sagital plane cutting methods in the treatment of patients with varus knee deformity

Background: Open wedge high tibial osteotomy (OWHTO) is commonly utilized to correct genu varum. To decrease various complications of OWHTO, some modifications are needed.   Methods: In a parallel randomized controlled clinical trial, 42 patients were divided into two groups: conventional OWHTO (control group) and OWHTO with the cut in the sagittal plane or distal tubercle osteotomy (OWHTO/DTO) (intervention group). Evaluation of the following items was conducted pre- and post-operatively: Knee Society Score (KSS) questionnaire, incidence of postoperative complications, patellar height by Blackburne-Peel (BP) ratio and Insall-Salvati Index (ISI), posterior tibial slope (PTS), tibiofemoral angle (TFA), Q-angle, medial proximal tibial angle (MPTA), three joint alignment radiography, and union radiological parameters.   Results: The differences between preoperative and postoperative variables including the KSS, PTS, TFA, BP Index (BPI), ISI, MPTA, and Q-angle within the intervention and control groups were not statistically significant. In four cases (3 in the control group and 1 in the intervention group), the delayed union was observed but the complete union was achieved after a mean of 23 weeks. No nonunion was observed.   Conclusion: Our results showed equal effectiveness for OWHTO/DTO compared with the conventional OWHTO.