Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026
No differences between medial opening and lateral closing wedge high tibial osteotomies to correct coronal alignment or cumulative rates of conversion to knee arthroplasty: A systematic review with meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
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Pinto Catarina, Gomes Eluana, Valente Cristina, Maier Leonard, Delgado Diego, Sanchez Mikel, Andrade Renato, Espregueira-Mendes João
Аннотация
PURPOSE: This systematic review with meta-analysis aimed to compare the accuracy correction of lateral closing wedge (LCW) and medial opening wedge (MOW) high tibial osteotomies (HTO) in patients with knee osteoarthritis (OA), and to evaluate the proportion of complications, reinterventions, revisions and conversion to knee arthroplasty.
METHODS: PubMed, EMBASE and Web of Science were searched until April 2024 to identify studies reporting imaging measurements, complications, reinterventions, revisions, and conversion to knee arthroplasty after HTO for knee OA. Meta-analysis was performed to compare LCW and MOW. Meta-analyses are reported as mean differences (MD) for continuous outcomes, or proportions and risk ratio (RR) for dichotomous outcomes, with 95% confidence intervals (CI).
RESULTS: A total of 103 studies (MOW, 43 studies; LCW, 33 studies; both techniques, 27 studies) were included comprising 12,200 knees from 11,472 patients (50.2% females, 52.4 ± 6.5 years old and 21.5 ± 12.2 kg/m²). Imaging measurements identified no significant differences between LCW and MOW in coronal plane alignment. Posterior tibial slope (PTS) was significantly higher in MOW as compared to the LCW (MD = 3.72°, 95% confidence interval [CI] 2.31°-5.13°). Proportion of complications was high at 22.2% (95% CI 17.6%-27.0%) and the conversion to knee arthroplasty was 6.4% (95% CI 2.7%-11.3%) at 5 years, 13.8% (95% CI 7.8%-21.1%) at 10 years and 33.4% (95% CI 15.0%-54.6%) at 15 years. There were no differences between MOW and LCW in risk of complications or proportion of conversion to knee arthroplasty, but risk of revision was lower in MOW (RR = 0.34, 95% CI 0.19-0.61).
CONCLUSIONS: The MOW and LCW were comparable to correct the lower limb coronal plane alignment, but the LCW was superior in reducing the PTS angle. Both techniques showed a similar risk profile for complications, reintervention and conversion to knee arthroplasty, but the MOW had a 66% lower risk for revision.
LEVEL OF EVIDENCE: Level IV.
METHODS: PubMed, EMBASE and Web of Science were searched until April 2024 to identify studies reporting imaging measurements, complications, reinterventions, revisions, and conversion to knee arthroplasty after HTO for knee OA. Meta-analysis was performed to compare LCW and MOW. Meta-analyses are reported as mean differences (MD) for continuous outcomes, or proportions and risk ratio (RR) for dichotomous outcomes, with 95% confidence intervals (CI).
RESULTS: A total of 103 studies (MOW, 43 studies; LCW, 33 studies; both techniques, 27 studies) were included comprising 12,200 knees from 11,472 patients (50.2% females, 52.4 ± 6.5 years old and 21.5 ± 12.2 kg/m²). Imaging measurements identified no significant differences between LCW and MOW in coronal plane alignment. Posterior tibial slope (PTS) was significantly higher in MOW as compared to the LCW (MD = 3.72°, 95% confidence interval [CI] 2.31°-5.13°). Proportion of complications was high at 22.2% (95% CI 17.6%-27.0%) and the conversion to knee arthroplasty was 6.4% (95% CI 2.7%-11.3%) at 5 years, 13.8% (95% CI 7.8%-21.1%) at 10 years and 33.4% (95% CI 15.0%-54.6%) at 15 years. There were no differences between MOW and LCW in risk of complications or proportion of conversion to knee arthroplasty, but risk of revision was lower in MOW (RR = 0.34, 95% CI 0.19-0.61).
CONCLUSIONS: The MOW and LCW were comparable to correct the lower limb coronal plane alignment, but the LCW was superior in reducing the PTS angle. Both techniques showed a similar risk profile for complications, reintervention and conversion to knee arthroplasty, but the MOW had a 66% lower risk for revision.
LEVEL OF EVIDENCE: Level IV.