Vol. 7, Issue 1, Part A (2025)

Introduction: Osteoarthritis (OA) of the knee is a leading cause of disability, particularly affecting the medial compartment in patients with varus deformity. High tibial osteotomy (HTO) is a joint-preserving surgical technique that redistributes load away from the degenerated medial compartment. Patients with younger age group replacements are not advisable so, high tibial osteotomy is one good option.

Aims and Objectives: To evaluate the functional and radiological outcomes of medial opening wedge high tibial osteotomy using a dynamic monorail external fixator and to correlate functional scores with the Hip-Knee-Ankle (HKA) angle.

Materials and Methods: This Retrospective study was conducted at Civil Hospital, Ahmedabad, for operated patients from October 2022 to September 2024. Thirty patients (18 females and 12 males) with medial compartment osteoarthritis underwent the procedure. The inclusion and exclusion criteria followed standard guidelines for HTO patient selection.

Results: The mean follow-up period was 10 months. The desired HKA angle (183-185°) was achieved in 90% of patients, with under-correction in two cases and overcorrection in one case. Functional scores showed significant improvements, with mean KOOS increasing from 46.4 to 82.42 and Oxford Knee Score improving from 19.3 to 38.9. The most common complication was pin tract infection, which was managed with antibiotics and proper care.

Conclusion: HTO using a dynamic monorail external fixator is an effective treatment for medial compartment osteoarthritis. It provides accurate correction without retained implants, preserves joint integrity, and results in significant functional improvements.