ANALYZING INEFFICACIES AND STRATEGIC INTERVENTIONS IN OPEN MEDIAL TIBIAL HIGH OSTEOTOMY FOR TREATING VARUS KNEE OSTEOARTHRITIS IN ATHLETES

Abstract

Objective: To analyze the causes of suboptimal outcomes in open medial tibial high osteotomy for treating varus knee osteoarthritis in athletes and to outline effective intervention strategies. Methods: This retrospective study examined 68 athletes treated with open medial tibial high osteotomy for varus knee osteoarthritis at our institution from January 2020 to January 2023. We evaluated changes in the Hospital for Special Surgery (HSS) knee function score, Visual Analogue Scale (VAS) for pain, and femorotibial angle preoperatively, and at 1, 3, and 6 months postoperatively. Statistical analyses assessed differences across these time points to identify factors contributing to poor outcomes and to develop corresponding intervention strategies. Results: Significant improvements were observed in HSS scores, VAS scores, and femorotibial angles at each subsequent time point post-surgery (P<0.05), with no significant differences in HSS scores between the 3 and 6-month marks (P>0.05). Specific analyses revealed that improvements in knee function and pain reduction were statistically significant from 1 to 6 months post-operation (P<0.05). Out of 68 surgeries, 12 patients experienced suboptimal outcomes, primarily due to inadequate postoperative pain management (6 cases), incision-related complications (3 cases), delayed bone healing (2 cases), and internal fixation failure (1 case). Conclusion: Open medial tibial high osteotomy generally offers substantial benefits for athletes with varus knee osteoarthritis when properly indicated and executed. Key to optimizing outcomes are strict adherence to surgical indications, precise measurement of lower limb force lines during surgery, and appropriate postoperative functional exercises to avoid premature weight-bearing and mitigate complication risks. These findings support the refinement of surgical techniques and postoperative protocols to enhance recovery and functional outcomes in this athletic population.