Medial Opening Wedge High Tibial Osteotomy for Medial Compartment Knee Osteoarthritis: Evidence from a Randomized Controlled Trial

Highlight

• Medial opening wedge high tibial osteotomy (HTO) significantly reduced medial tibiofemoral cartilage loss over 2 years compared to nonsurgical management alone.
• HTO provided clinically meaningful improvements in patient-reported outcomes (KOOS) for knee osteoarthritis with varus alignment.
• The study used blinded MRI assessment of cartilage thickness and included a parallel preference arm to enhance generalizability.
• Findings support HTO as a joint-preserving intervention for selected patients with medial compartment knee osteoarthritis.

Background