Genu Varum Correction: A Comparison of Conventional Open Wedge High Tibial Osteotomy versus Open Wedge Osteotomy with Sagittal Plane Cutting

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.