Clinical Outcomes and Complications of Medial Open-Wedge High Tibial Osteotomy with TomoFix Plate in Patients with Medial Compartment Knee Osteoarthritis at Chumphon Khet Udomsakdi Hospital, Chumphon Province
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Abstract
Medial compartment knee osteoarthritis is a major cause of pain and disability, particularly in patients with varus alignment. Medial open wedge high tibial osteotomy (MOWHTO) is a surgical option that corrects lower limb alignment and reduces joint loading; however, outcome data in general hospital settings remain limited. This retrospective analytical study aimed to evaluate clinical outcomes, radiological outcomes, bone union, and complications following MOWHTO using a TomoFix plate in patients with medial compartment knee osteoarthritis at Chumphon Khet Udomsakdi Hospital. A total of 31 patients (31 knees) who underwent surgery between 2015 and 2025 were included. Data were analyzed using descriptive statistics and paired t-test.
The results showed that most patients were female (90.3%), with a mean age of 57.4 (SD 6.9) years, and the majority were overweight or obese (87.1%). Postoperatively, the JOA score and knee flexion angle significantly improved (p < 0.001), while knee extension showed no significant change. All patients achieved a good level of knee function (100%). Radiological parameters, including FTA, WBL, PTS, and Caton–Deschamps Index, showed significant changes (p < 0.001), indicating appropriate alignment correction. Bone union was achieved in all cases (100%), with no delayed union or non-union. The overall complication rate was 19.4%, with major complications observed in 3.2%.
In conclusion, MOWHTO using a TomoFix plate provides favorable clinical and radiological outcomes, with a high rate of bone union and an acceptable safety profile. It is an effective treatment option for patients with medial compartment knee osteoarthritis.
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References
Dell’Isola A, Recenti F, Giardulli B, Lawford BJ, Kiadaliri A. Osteoarthritis year in review 2025: epidemiology and therapy. Osteoarthritis Cartilage. 2025;33(11):1300-6. doi: 10.1016/j.joca.2025.08.015
Courties A, Kouki I, Soliman N, Mathieu S, Sellam J. Osteoarthritis year in review 2024: epidemiology and therapy. Osteoarthritis Cartilage. 2024;32(11):1397-404. doi: 10.1016/j.joca.2024.07.014
Rodríguez-Reyes D, Vargas-Figueroa R, Vázquez-Lloret AS, Luigi Martinez HE, Gonzalez-Diaz G, Señeriz Ortiz R. Nonoperative management recommendations for knee osteoarthritis: a review of clinical guidelines and treatment alternatives. Cureus. 2025;17(10):e95540. doi: 10.7759/cureus.95540
Palmer J, Getgood A, Lobenhoffer P, Nakamura R, Monk P. Medial opening wedge high tibial osteotomy for the treatment of medial unicompartmental knee osteoarthritis: a state-of-the-art review. J ISAKOS. 2024;9(1):39-52. doi: 10.1016/j.jisako.2023.10.004
Park HU, Bäcker HC, Häner M, Braun KF, Petersen W. Clinical outcome after medial open-wedge high tibial osteotomy: comparison of two angular stable locking plates—TomoFix versus LOQTEQ HTO plate. J Pers Med. 2023;13(3):472. doi: 10.3390/jpm13030472
Yoshida S, Nishitani K, Yoshitomi H, Kuriyama S, Nakamura S, Fujii T, et al. Knee alignment correction by high tibial osteotomy reduces symptoms and synovial inflammation in knee osteoarthritis accompanied by macrophage phenotypic change from M1 to M2. Arthritis Rheumatol. 2023;75(6):950-60. doi: 10.1002/art.42424
Hu Q, Jiang J, Li Q, Lu S, Xie J. A systematic review and meta-analysis examining alterations in medial meniscus extrusion and clinical outcomes following high tibial osteotomy. J Orthop. 2025;68:121-30. doi: 10.1016/j.jor.2025.01.036
Miltenberg B, Puzzitiello RN, Ruelos VCB, Masood R, Pagani NR, Moverman MA, et al. Incidence of complications and revision surgery after high tibial osteotomy: a systematic review. Am J Sports Med. 2024;52(1):258-68. doi: 10.1177/03635465221142868
Zhang S, Ji C, Liu S, Tong W, Qin L, Zhu Y. Incidence of deep venous thrombosis following medial opening-wedge high tibial osteotomy for varus knee osteoarthritis: a retrospective study. BMC Musculoskelet Disord. 2025;26(1):476. doi: 10.1186/s12891-025-08713-w
Mabrouk A, An JS, Fernandes LR, Kley K, Jacquet C, Ollivier M. Maintaining posterior tibial slope and patellar height during medial opening wedge high tibial osteotomy. Orthop J Sports Med. 2023;11(12):23259671231213595. doi: 10.1177/23259671231213595
Lott A, James MG, Kaarre J, Höger S, Kayaalp ME, Ollivier M, et al. Around-the-knee osteotomies part II: surgical indications, techniques and outcomes—state of the art. J ISAKOS. 2024;9(4):658-71. doi: 10.1016/j.jisako.2024.04.002
Arai Y, Nakagawa S, Inoue A, Fujii Y, Cha R, Nakamura K, et al. Long-term outcomes and prognostic factors of medial open wedge high tibial osteotomy for medial compartment knee osteoarthritis or osteonecrosis. J Clin Med. 2025;14(7):2294. doi: 10.3390/jcm14072294
Ahrend MD, Petzold D, Histing T, Ihle C, Schröter S, Herbst M. High survival rates and patient satisfaction 12 years after medial open wedge high tibial osteotomy surgery: a prospective cohort study. Knee Surg Sports Traumatol Arthrosc. 2025;33(12):4344-52. doi: 10.1002/ksa.70071
Yoon WK, Kim KI, Kim JH, Lee SH, Jo MG. Does degeneration of the patellofemoral joint after medial open-wedge high tibial osteotomy affect clinical outcomes? Am J Sports Med. 2022;50(11):2972-9. doi: 10.1177/03635465221113324
Yapıcı F. High Tibial Osteotomy (HTO), Unicompartmental Knee Arthroplasty (UKA), and Proximal Fibular Osteotomy (PFO) for Medial-Compartment Knee Osteoarthritis: A Narrative Review of Comparative Mechanisms, Clinical Outcomes, and Decision-Making. J Clin Med. 2025;14(21):7882. doi: 10.3390/jcm14217882
