Evaluation of High Tibial Osteotomy With or Without Arthroscopic Partial Lateral Patellar Facetectomy for Combined Patellofemoral and Medial Compartment Knee Osteoarthritis A Comparative Randomized Study

What this Trial Is About

This research aims to evaluate the outcomes of treating patients with combined patellofemoral and medial compartment knee osteoarthritis using open wedge high tibial osteotomy (OWHTO) either with or without arthroscopic partial lateral patellar facetectomy. The study involves patients aged 35 to 60 years with mild to moderate tibiofemoral osteoarthritis and anterior knee pain without lateral compartment involvement. It compares the results of these two surgical approaches to better understand their effects on knee function and pain. All patients will undergo OWHTO performed by the same surgical team using a standardized technique recommended by the AO international knee expert group. Participants will be randomly assigned to receive either OWHTO combined with arthroscopic partial lateral patellar facetectomy or OWHTO alone. The facetectomy involves arthroscopic removal of the overhanging lateral patellar facet to improve patellar mobility. The osteotomy is biplanar and stabilized with a Tomofix plate without additional bone grafts, followed by layered wound closure. Participants will be followed for two years after surgery, with evaluations at 2 weeks, 4 weeks, 6 weeks, 6 months, 1 year, and 2 years postoperatively. Assessments include the Knee injury and Osteoarthritis Outcome Score (KOOS) and the Kujala Score (Anterior Knee Pain Scale) to measure knee function and pain. Researchers will monitor recovery progress, knee mobility, and patellar tracking to assess treatment effectiveness and safety over time.

Management of Combined Patellofemoral and Medial Compartment Knee Osteoarthritis