High tibial osteotomy is an established surgical option for medial compartment osteoarthritis of the knee with varus alignment. It can be divided into open wedge and closing wedge by operative technique. Although they have fundamental differences, little is known about the biomechanical consequences of the two surgical methods. Thirty-eight patients with medial compartment osteoarthritis who underwent high tibial osteotomy (19 open-wedge and 19 closing-wedge) were retrospectively reviewed. Clinical scores and radiological measurements were assessed until postoperative two years. Gait analysis was performed preoperatively and again at postoperative one year. Varus alignment was corrected in both groups without a significant difference between them ( = 0.543). However, posterior tibial slope was higher, and the Blackburne-Peel ratio was lower in the open wedge osteotomy group after surgery (both < 0.001). Reduction of dynamic knee varus and knee adduction moment were observed in both groups without significant differences. However, after surgery, average knee range of motion (63.3° vs 57.3°, < 0.001) and the magnitude of knee flexion moment was significantly lower ( = 0.005) in the closing wedge group. There were no significant differences in the Kujala Anterior Knee Pain Scale and the occurrence of patellofemoral arthritis between the groups postoperatively. After osteotomy, a smaller average knee range of motion in the sagittal plane and a higher knee flexion moment were observed in the open wedge osteotomy group, suggesting quadriceps muscle avoidance. However, no differences in clinical scores or the short-term occurrence of patellofemoral arthritis were noted between the two surgical techniques.

中文翻译：

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步态对比分析：闭合楔形与开放楔形胫骨高位截骨术冠状位相似但矢状位效应不同

胫骨高位截骨术是治疗膝关节内翻骨关节炎的既定手术选择。按手术技术可分为开放楔形和闭合楔形。尽管它们存在根本差异，但人们对这两种手术方法的生物力学后果知之甚少。回顾性分析了 38 例接受胫骨高位截骨术（19 例开放楔形截骨术和 19 例闭合楔形截骨术）的内侧间室骨关节炎患者。评估临床评分和放射学测量结果直至术后两年。术前和术后一年再次进行步态分析。两组的内翻对齐均得到纠正，但两组之间没有显着差异 (= 0.543)。然而，开放楔形截骨组术后胫骨后坡度较高，Blackburne-Peel 比值较低（均 < 0.001）。两组均观察到动态膝内翻和膝内收力矩的减少，但没有显着差异。然而，手术后，闭合楔形组的平均膝关节活动范围（63.3° vs 57.3°，< 0.001）和膝关节屈曲力矩的大小显着较低（= 0.005）。术后各组间Kujala前膝疼痛量表及髌股关节炎发生情况均无显着性差异。截骨后，开放楔形截骨组观察到膝关节在矢状面的平均运动范围较小，膝关节屈曲力矩较高，表明股四头肌回避。然而，两种手术技术之间的临床评分或髌股关节炎的短期发生率没有差异。