A Modified (Retro-Tubercle) Opening Wedge High Tibial Osteotomy Versus the Conventional Technique

Study Overview
=================
Brief Summary
-----------------
The present study was conducted among a group of Iranian patients suffering from varus knee in order to compare advantages and disadvantages of ROWHTO (Retro-Tubercle Opening Wedge High Tibial Osteotomy) technique when compared with previously described approaches of opening-wedge osteotomy.

Detailed Description
-----------------
There are various methods for correcting varus deformity; therefore the best surgical method must be individualized. We concluded that in a varus knee where only correction in the coronal plane without patella infra, changes in Q- angle, tibial plateau inclination is all that is needed, a retro- tubercle medial opening- wedge osteotomy is the preferred approach.

Official Title
-----------------
A Modified (Retro-Tubercle) Opening Wedge High Tibial Osteotomy Versus the Conventional Technique

Conditions
-----------------
Genu Varum

Intervention / Treatment
-----------------
* Procedure: Retro-Tubercle Opening-Wedge High Tibial Osteotomy


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: symptomatic varus deformity of the knee with 2 or more degrees of anatomical axis varus without ligament injury Exclusion Criteria: fractures through compartments of the knee or the patella osteoarthritis other than in the medial compartment 10 degrees or more extension lag tibial malrotation
Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Medial Opening-Wedge Osteotomy<br>Medial Opening-Wedge Osteotomy (MOWO) is an approach for the correction of malalignment of the knee | Procedure: Retro-Tubercle Opening-Wedge High Tibial Osteotomy<br>* Retro-Tubercle Opening-Wedge High Tibial Osteotomy (ROWHTO) is among the latest approaches for the treatment of varus deformity of knee.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The proportion of patellar length (in mm)to the patellar tendon length (in mm) | The length of the patella (in its longest diameter on a lateral x-ray) to the length of the patellar tendon is referred as Insall-Salvati index | up to 13 months | 
| The proportion of patellar articular surface length (in mm)to the patella-tibial plateau distance (in mm) | The length of the articular surface of the patella to the distance from the patella to the tibial plateau is referred as Blackburne-Peel index. | up to 13 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quadriceps angle in degree | The angle between the quadriceps vector and the line of pull of the patellar tendon from the centre of the patella to the tibial tubercle. | up to 13 months | 
| Inclination of proximal tibial plateau in degree | The angle between articular surface and lateral longitudinal axis of tibia. | up to 13 months |