High tibial osteotomies − is it still a reasonable option in treatment of osteoarthritis?

Background
High tibial osteotomies (HTO) and unicompartmental knee arthroplasties are performed for the treatment of isolated unicompartmental osteoarthritis (OA) of the knee. Before the development of knee arthroplasties, HTO was the most common operative treatment option for knee OA.
Patients and methods
This work was a prospective study on 27 patients with medial compartmental OA who had been admitted to El-Menoufia University Hospital in the period from 2009 to 2013.
Results
The average age of the patients was 43 years. The average opening height of the osteotomy was 10.8 mm. There were no cases of secondary loss of correction. No patients needed to be treated by a secondary autograft because of delayed bone healing. One patient was reoperated a few days after the first intervention because of overcorrection.
Conclusion
Open-wedge HTO with the use of optimal surgical techniques (biplanar metaphyseal osteotomy) and the fixation with the internal plate fixator TomoFix has proved to be successful in treatment of unicompartmental gonarthrosis, even without bone grafts or bone substitute material. The complication rate is small, and full weight-bearing is achieved quickly with good medium-term results.