title: Opening-wedge high tibial osteotomy: a seven - to twelve-year study.
abstract: OBJECTIVE
  medial opening-wedge osteotomy is a widely performed procedure used to treat moderate isolated medial knee osteoarthritis. Historically, the literature has contained reports showing satisfactory mid-term results when accurate patient selection and precise surgical techniques were applied. This study was conducted to investigate the clinical and radiographic seven- to twelve-year results of opening-wedge high tibial osteotomy in a consecutive series of patients affected by varus knee malalignment with isolated medial compartment degenerative joint disease.
  
  
  METHODS
  we reviewed a case series of 147 medial opening-wedge high tibial osteotomies at an average follow-up of 9.5 years. Endpoints for evaluation included the reporting of adverse effects, radiographic evidence of bone union, radiographic changes in the correction angle during union, and clinical and functional final outcomes.
  
  
  RESULTS
  good or excellent results were obtained in 94% of the cases: the patients reported no major complications related to the opening-wedge high tibial osteotomy surgical technique, bone graft resorption, implant choice or postoperative rehabilitation protocol. At final follow-up, the average hip-knee angle was 4° of valgus without major loss of correction during the healing process. A statistically significant change in the patellar height was detected postoperatively, with a trend towards patella infera.
  
  
  CONCLUSIONS
  medial opening-wedge high tibial osteotomy is still a reliable method for correcting varus deformity while producing stable fixation, thus allowing satisfactory stability, adequate bone healing and satisfactory mid- to long-term results.
  
  
  METHODS
  Level IV, therapeutic cases series.
authors.affiliation: Ludes University, Lugano, Switzerland.
authors.forename: Gennaro
authors.initials: G
authors.lastname: Pipino
authors.affiliation: Department of Orthopaedic Surgery, Stanford University, Palo Alto, USA.
authors.forename: Pier Francesco
authors.initials: PF
authors.lastname: Indelli
authors.affiliation: Ospedale Maggiore Bologna, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Tigani
authors.affiliation: Ludes University, Lugano, Switzerland.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Maffei
authors.affiliation: Ludes University, Lugano, Switzerland.
authors.forename: Davide
authors.initials: D
authors.lastname: Vaccarisi
keywords: high tibial osteotomy; knee; opening-wedge osteotomy; osteoarthritis; osteotomy