To retrospectively analyze the clinical efficacy of arthroscopy combined with medial high biplanar tibial osteotomy in the treatment of medial compartment knee osteoarthritis.

From August 2018 to January 2022, 28 patients (29 knees) with medial compartment knee osteoarthritis were successfully followed up under the concept of enhanced recovery after arthroscopic exploration combined with high medial tibial osteotomy at Shougang Hospital, Peking University, including 3 males (3 knees) and 25 females (26 knees). Their average age was (57.8±6.2) years (range, 45~71 years). The visual analogue scale (VAS), HSS knee score, Lysholm score, and knee range of motion (ROM) were used to evaluate the postoperative efficacy. Preoperative and postoperative standard anteroposterial-lateral radiographs were used to measure tibiofemoral angle (FTA) and medial proximal tibia angle (MPTA) to record the range of motion of the knee at 3 months after operation. The occurrence of complications was recorded. Paired t test was used for statistical analysis, and P＜0.01 was considered statistically significant.

The patients were followed up for 8~48 months, with an average of (25.8±12.8) months. Arthroscopic examination revealed 29 knees combined with other injuries, including meniscus tear (29 knees), articular cartilage injury (29 knees), stenosis of intercondylar fossa (9 knees), cartilage free body (6 knees), etc. The varus deformity was effectively corrected after operation. VAS score [(6.28±0.649) vs (1.52±0.509)], HSS score [(62.34±4.125) vs (89.48±2.544)], Lysholm score [(57.17±3.855) vs (79.93±4.200)], FTA [(183.87±1.604)° vs (174.85±0.834)°], MPTA [(83.39±0.997)° vs (89.99±1.372)°], and the range of motion of the knee joint [(105±7.559)° vs (126.90±4.100)° were significantly improved 3 months after operation compared with those before operation (P＜0.01). During the follow-up period, 1 case had wound infection 3 months after operation, and the wound healed after debridement and VSD treatment. No failure of internal fixation was observed, and no nonunion of osteotomy site was found.

Arthroscopic exploration combined with high tibial osteotomy can effectively correct the force line of the affected limb, relieve pain symptoms, and timely detect other structural injuries in the joint, as well as take intervention measures simultaneously representing a safe and effective method for the treatment of medial compartment knee osteoarthritis.