Evaluation of Uniplanar Open Wedge High Tibial Osteotomy in Management of Genu Varum in Adults

Background: Genu varum is a common deformity that leads to increased medial compartment loading and progressive osteoarthritis of the knee. High tibial osteotomy (HTO) is a well-established joint-preserving procedure that corrects malalignment and redistributes load. Among its variations, the uniplanar medial open-wedge method offers accurate correction with minimal complications. Aim: This research aimed to assess the short-term functional and radiological results of uniplanar medial open-wedge high tibial osteotomy in adult patients with genu varum. Methods: Prospective research has been performed on twenty adult cases had symptomatic genu varum who underwent uniplanar medial open-wedge HTO utilizing a T-buttress plate and autologous iliac crest bone graft. Patients were followed for at least twelve months. Clinical results have been evaluated utilizing the Visual Analogue Scale (VAS) and Lysholm Knee Scoring Scale (LKSS), while radiological parameters included varus angle, medial proximal tibial angle (MPTA), mechanical lateral distal femoral angle (mLDFA), tibial slope and patellar height (Insall–Salvati index). Results: The mean age of patients was 34.65 ± 9.92 years, with 11 males (55%) and 9 females (45%). Postoperatively, VAS significantly enhanced from 8.15 ± 0.67 to 3.45 ± 0.94 (p = 0.001), and LKSS increased from 53.65 ± 8.85 to 86.6 ± 7.08 (p = 0.001). Based on LKSS grading, 5 patients (25%) achieved excellent, 13 (65%) good, and 2 (10%) fair to poor outcomes. Radiologically, varus angle improved from 12.83 ± 3.96° to 0.76 ± 3.45° (p < 0.001) and MPTA from 80.31 ± 2.74° to 89.72 ± 2.04° (p < 0.001). The tibial slope and patellar height showed slight, non-significant changes. Complications occurred in 3 patients (15%): Infection (5%), delayed union (5%) and lateral hinge fracture (5%), all managed conservatively with complete recovery. Conclusion: Uniplanar medial open-wedge high tibial osteotomy resulted in significant functional improvement, pain relief and precise alignment correction in patients with genu varum with minimal complications. It remains an effective joint-preserving option for young and middle-aged adults with medial compartment overload.