Tibial slope alteration in medial open-wedge high tibial osteotomy with and without a bone graft: a double cohort study

Introduction Medial open-wedge high tibial osteotomy (OWHTO) has become one of the most common procedures for correction of varus knee deformities. The need for an autogenous bone graft with its associated morbidity and a change in the posterior tibial slope with its sequelae are some of its potential drawbacks. Patients and methods Ninety-two patients with varus deformities and medial compartment osteoarthritis were prospectively divided into two groups: group I, comprising patients who had undergone an OWHTO with an iliac crest graft, and group II, comprising patients who had undergone an OWHTO without a bone graft. These two groups were compared with respect to the posterior tibial slope, radiological outcome, and functional outcome of the two techniques. Results There was no significant difference between the two groups with regard to the correction achieved in femorotibial angle or posterior tibial slope. A significant increase was observed in both groups when preoperative and postoperative measurements were compared. Both groups showed improved functional results on the knee society knee scoring system, with no significant difference between them. Conclusion OWHTO can be performed without a graft with less operative time and with similar clinical and radiological results in terms of bone union and posterior tibial slope alteration.