To evaluate the clinical efficacy of open wedge high tibial osteotomy (OWHTO)and closed wedge high tibial osteotomy(CWHTO) in the medial compartment osteoarthritis of patients with high quality by meta-analysis, in order to give some evidences for the choice of method dealing with the medial compartment osteoarthritis of patients.

Cochrane Central Register of Controlled Trials (Issue 6 2017), Pubmed, Ovid, Spinger Link, Elsevier, Medline were searched (time range: 1970-01-01 to 2017-6-30). OWHTO and the CWHTO were used in treating the medial compartment osteoarthritis of patients in the literature. The related literatures including complications, operating time, Hospital for Special Surgery(HSS) knee score, patellar height, mean correction angle, posterior tibial slope angle and hip-knee-ankle angle were explored.A strict quality assessment was performed to screen the literatures which met the inclusion criteria. The analysis was performed with software RevMan5.0 from the Cochrane collaboration. Additionally, the heterogeneity of data was also checked.

Thirteen relevant articles were included in the standard, and the total sample size was 1 237 cases, including OWHTO group of 666 cases, 571 cases of the CWHTO group. Comparing the OWHTO group with the CWHTO group, there were significant differences in the postoperative patellar height Caton-Deschamps measurement index, postoperative posterior tibial slope angle and operation time[weighted mean difference (WMD)=0.11, 95% confidence interval (CI)(-0.17, -0.05), P<0.0001], [WMD=2.61, 95%CI(2.13, 3.10), P<0.0001]. There was significant difference in the peroperative hip-knee-ankle angle changes of the CWHTO group [WMD=0.82, 95%CI(0.04, 1.59), P=0.04]. There was no significant difference between the OWHTO group and the CWHTO group in complications[WMD=1.55 95%CI(0.35, 6.93), P=0.57], visual analogue scale (VAS) [WMD=0.46, 95%CI(-0.15, 1.06), P=0.14], preoperative HSS score[WMD=1.72, 95%CI(-1.27, 4.71), P=0.26] and postoperative HSS score[WMD=0.70, 95%CI(-1.48, 2.89), P=0.69], postoperative mean correction angle[WMD=2.61, 95%CI(2.13, 3.10), P<0.0001], postoperative hip-knee-ankle angle [WMD=0.21, 95%CI(-0.67, 1.09), P=0.64], preoperative patellar height Blackburne-Peel(BP) measurement index[WMD=0.03, 95%CI (-0.01, 0.07), P=0.12] and postoperative patellar height BP measurement index[WMD=-0.03, 95%CI(-0.02, 0.07), P=0.31], preoperative patellar height Insall-Salvati measurement index(ISI) [WMD=0.02, 95%CI(-0.08, 0.02), P=0.31]and postoperative patellar height ISI [WMD=-0.02, 95%CI(-0.06, 0.02), P=0.31]and preoperative posterior tibial slope angle[WMD=0.58, 95%CI(-0.06, 1.23), P=0.08].

Compared with CWHTO, in the treatment of medial compartment osteoarthritis, OWHTO can increase the posterior tibial slope angle, reduce patella height and correct hip-knee-ankle angle and shorten operation time, which is a better choice for treatment of medial compartment osteoarthritis.