Early gait recovery following medial open-wedge high tibial osteotomy: A prospective gait analysis study
Mehmet Musa Emir1
, Özgür Selim Uysal2, Gurbat Javadov3, Sinan Yılmaz4, Jihad Hajouj5, Umut Öktem6, Emre Adıgüzel6, Osman Tecimel7, Durmuş Ali Öçgüder6
1Department of Orthopedics and Traumatology, Batman Iluh State Hospital, Batman, Türkiye
2Department of Orthopedics and Traumatology, Özel 100.Yıl Hospital, Ankara, Türkiye
3Department of Orthopedics and Traumatology, Muradiye State Hospital, Van, Türkiye
4Department of Orthopedics and Traumatology, Memorial Ankara Hospital, Ankara, Türkiye
5Department of Orthopedics and Traumatology, Özel TOBB ETÜ Hospital, Ankara, Türkiye
6Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Türkiye
7Department of Orthopedics and Traumatology, Memorial Ankara Hospital, Ankara, Türkiye
Keywords: Gait analysis; high tibial osteotomy, knee osteoarthritis, medial open-wedge osteotomy, Oxford knee score.
Abstract
Objectives: This study aims to evaluate the effects of medial openwedge high tibial osteotomy (OWHTO) on gait analysis outcomes in patients with medial compartment osteoarthritis and varus alignment of the knee.
Patients and methods: This prospective, observational study included a total of 22 patients who underwent biplanar medial OWHTO between February 2023 and March 2024 were included. Gait analysis was performed preoperatively and at the sixth postoperative month using the 4D Diers Formetric system. Early postoperative (6 months) gait parameters, angular parameters (tibial slope and correction angle), and joint kinematics were evaluated. Patient-reported outcomes were obtained using the Oxford Knee Score (OKS) to assess pain and physical function before and after the procedure.
Results: Of a total of 22 patients included in the study, 4 were male and 18 were female with a mean age of 55.41 ± 5.86 (range, 47 to 63) years. Postoperatively, patients’ walking speed (0.83 ± 1.12 m/s), step length (0.58 ± 0.73 m), and cadence (82.72 ± 92.05 steps/min) increased significantly (p < 0.001). The tibial slope angle showed a mean increase of 1.93° (p < 0.001). The mean correction angle was 7.53°. The mean knee flexion increased significantly from 35.05° ± 8.74° preoperatively to 52.96° ± 13.21° postoperatively (p < 0.001). Knee extension improved minimally but significantly from –7.55° ± 1.18° to –6.03° ± 0.05° (p = 0.046). Ankle dorsiflexion increased significantly (p < 0.001), whereas changes in plantar flexion were not statistically significant. The OKS score increased significantly from 18.30 preoperatively to 41.50 at the sixth postoperative month (p < 0.001).
Conclusion: Medial OWHTO results in early improvements in walking speed, step length, and cadence, as well as enhanced knee flexion kinematics and patient-reported outcomes. These findings indicate that OWHTO is an effective surgical option contributing to the improvement of gait patterns in the early postoperative period.
Citation: Emir MM, Uysal ÖS, Javadov G, Yılmaz S, Hajouj J, Öktem U, et al. Early gait recovery following medial open-wedge high tibial osteotomy: A prospective gait analysis study. Jt Dis Relat Surg 2026;37(3):768-776. doi: 10.52312/jdrs.2026.2776.