A Randomised Clinical Trial Using Radiostereometry

J Bone Joint Surg [Br] 2009;91-B:1459-65. Received 18 March 2009; Accepted after revision 19 June 2009 Valgus high tibial osteotomy for osteoarthritis of the medial compartment of the knee can be performed using medial openingand lateral closing-wedge techniques. The latter have been thought to offer greater initial stability. We measured and compared the stability of openingand closing-wedge osteotomies fixed by TomoFix plates using radiostereometry in a series of 42 patients in a prospective, randomised clinical trial. There were no differences between the openingand closing-wedge groups in the time to regain knee function and full weight-bearing. Pain and knee function were significantly improved in both groups without any differences between them. All the osteotomies united within one year. Radiostereometry showed no clinically relevant movement of bone or differences between either group. Medial opening-wedge high tibial osteotomy secured by a TomoFix plate offers equal stability to a lateral closing-wedge technique. Both give excellent initial stability and provide significantly improved knee function and reduction in pain, although the openingwedge technique was more likely to produce the intended correction.