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Joint Diseases and
Related Surgery
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Original Article · Open access

Early gait recovery following medial open-wedge high tibial osteotomy: A prospective gait analysis study

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Mehmet Musa Emir

Department of Orthopedics and Traumatology, Batman Iluh State Hospital, Batman, Türkiye

ORCID: 0009-0009-3241-4826

Özgür Selim Uysal

Department of Orthopedics and Traumatology, Özel 100.Yıl Hospital, Ankara, Türkiye

ORCID: 0000-0002-6433-7548

Gurbat Javadov

Department of Orthopedics and Traumatology, Muradiye State Hospital, Van, Türkiye

ORCID: 0009-0001-3749-1929

Sinan Yılmaz

Department of Orthopedics and Traumatology, Memorial Ankara Hospital, Ankara, Türkiye

ORCID: 0000-0002-6683-8178

Jihad Hajouj

Department of Orthopedics and Traumatology, Özel TOBB ETÜ Hospital, Ankara, Türkiye

ORCID: 0009-0003-6392-6337

Umut Öktem

Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Türkiye

ORCID: 0000-0001-8436-8934

Emre Adıgüzel

Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Türkiye

ORCID: 0000-0002-2447-5065

Osman Tecimel

Department of Orthopedics and Traumatology, Memorial Ankara Hospital, Ankara, Türkiye

ORCID: 0000-0001-8181-1128

Durmuş Ali Öçgüder

Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Türkiye

ORCID: 0000-0003-3610-0938

Abstract

Objectives: This study aims to evaluate the effects of medial openwedge high tibial osteotomy (OWHTO) on gait analysis outcomes in patients with medial compartment osteoarthritis and varus alignment of the knee.

Patients and methods: This prospective, observational study included a total of 22 patients who underwent biplanar medial OWHTO between February 2023 and March 2024 were included. Gait analysis was performed preoperatively and at the sixth postoperative month using the 4D Diers Formetric system. Early postoperative (6 months) gait parameters, angular parameters (tibial slope and correction angle), and joint kinematics were evaluated. Patient-reported outcomes were obtained using the Oxford Knee Score (OKS) to assess pain and physical function before and after the procedure.

Results: Of a total of 22 patients included in the study, 4 were male and 18 were female with a mean age of 55.41 ± 5.86 (range, 47 to 63) years. Postoperatively, patients’ walking speed (0.83 ± 1.12 m/s), step length (0.58 ± 0.73 m), and cadence (82.72 ± 92.05 steps/min) increased significantly (p < 0.001). The tibial slope angle showed a mean increase of 1.93° (p < 0.001). The mean correction angle was 7.53°. The mean knee flexion increased significantly from 35.05° ± 8.74° preoperatively to 52.96° ± 13.21° postoperatively (p < 0.001). Knee extension improved minimally but significantly from –7.55° ± 1.18° to –6.03° ± 0.05° (p = 0.046). Ankle dorsiflexion increased significantly (p < 0.001), whereas changes in plantar flexion were not statistically significant. The OKS score increased significantly from 18.30 preoperatively to 41.50 at the sixth postoperative month (p < 0.001).

Conclusion: Medial OWHTO results in early improvements in walking speed, step length, and cadence, as well as enhanced knee flexion kinematics and patient-reported outcomes. These findings indicate that OWHTO is an effective surgical option contributing to the improvement of gait patterns in the early postoperative period.

Declarations

Author Contributions

M.M.E.: Concept/idea, design, supervision/control, data collection and processing, analysis and interpretation, critical review, literature search, manuscript writing; Ö.S.U.: Manuscript review and editing; J.H., G.J.: Literature search; U.Ö.: Manuscript writing; E.A.: Analysis, processing, and interpretation of gait analysis data; O.T., D.A.Ö.: Concept/idea, design, critical review.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

AI Disclosure

The authors declare that artificial intelligence (AI) tools were not used, or were used solely for language editing, and had no role in data analysis, interpretation, or the formulation of conclusions. All scientific content, data interpretation, and conclusions are the sole responsibility of the authors. The authors further confirm that AI tools were not used to generate, fabricate, or ‘hallucinate’ references, and that all references have been carefully verified for accuracy.

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