An interventional study of Hybrid Closed Wedge High Tibial Osteotomy in Patello-femoral Osteoarthritis, sponsored by Assiut University. Not yet recruiting. Open to participants aged 18 Years to 70 Years. Per ClinicalTrials.gov, last updated 2026-10-30.
Sponsored by Assiut University · Not applicable, Interventional, and Treatment
Osteoarthritis (OA) is the most prevalent condition of the knee joint. High tibial osteotomy (HTO) is an effective treatment for medial compartmental osteoarthritis (OA) of the knee with good clinical outcomes. In particular, the two most commonly used surgical techniques of HTO are medial open wedge HTO (OWHTO) and lateral closed wedge HTO (CWHTO). However, OWHTO has been reported to have a negative effect on the patellofemoral (PF) joint postoperatively due to a decrease in patellar height and an increase in PF contact pressure, in contrast to CWHTO. Biomechanical studies indicated that the alteration in patellar height can be attributed to distalization of the tibial tuberosity following OWHTO, which leads to the patella being pulled down toward the joint lines. In CWHTO, the tibial tuberosity was reported to move proximally in a biomechanical study. Therefore, CWHTO may lead to improvement of PF joint congruity compared with descending OWHTO. Meanwhile, CWHTO has also been reported to have several disadvantages, such as loss of the large bone block below the lateral tibial plateau, increase in lateral offset due to the horizontal osteotomy, and late full weight-bearing walking. To improve these disadvantages, the hybrid closed wedge HTO (HCWHTO) technique, a kind of CWHTO, was developed. The points of difference for HCWHTO compared with conventional CWHTO are an oblique osteotomy to achieve a large contact area, a contact for the lateral cortices in the proximal and distal fragments without lateral offset for early full weight-bearing, and a removal of a smaller bone wedge to maintain leg length. Furthermore, this procedure has good effects on PF joint congruity through improvement in tibial tuberosity-trochlear groove distance and the proximalization of the tibial tuberosity when compared with OWHTO If a patient has PF-OA preoperatively, HCWHTO may be chosen to prevent progression of PF-OA postoperatively. However, HCWHTO may be performed in patients with varus deformity of the knee combined with PF-OA, because progression of PF-OA is correlated with varus knee .
2,974 studies on the registry are indexed under Osteoarthritis; 438 are open to participants now.
This study's planned enrollment of 20 is below the median of 80 across 2,240 interventional studies indexed under Osteoarthritis.
Browse Osteoarthritis studies →Assiut University is the lead sponsor of 5,078 studies on the registry; 2,178 are open to participants now.
Of its 14 completed or terminated interventional studies of FDA-regulated products, 0 (0%) have results posted.
Counted across the registry records on this site, refreshed daily.
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Patients with medial knee compartment osteoarthritis and genu varum deformity who undergo Hybrid Closed Wedge High Tibial Osteotomy (HCWHTO) with arthroscopic lateral retinacular release, followed by clinical and radiological follow-up at 6 weeks, 6 months, and 12 months postoperatively
Procedure: Hybrid Closed Wedge High Tibial Osteotomy
Under knee arthroscopy, lateral retinacular release (LRR) of the PF joint will be performed. Before the tibial osteotomy, the fibular osteotomy at the mid-portion and segmental resection will be performed. The tibia will undergo biplanar osteotomy. The hinge point that divides the proximal tibial osteotomy line by approximately 2-1 will be then determined. After removal of the lateral closed wedge bone block, the medial side will be opened, and the lateral side will be closed. A lateral tibial haed plate will be inserted on the lateral side of the tibia after plate bending for the proximal screws to become parallel to the tibial plateau and will be fixed in place with locking screws with. * Osteotomy opening angle and correction will be achieved intraoperatively. * Type of fixation device will be used (plate/screws)
Also known as: HCWHTO
Clinical improvement by KOOS Functional knee score
Validated knee scoring systems will be recorded preoperatively and during follow-up by Knee injury and Osteoarthritis Outcome Score (KOOS) The standard full-length KOOS consists of 42 items divided into 5 separate subscales: * Pain (9 items) * Other Symptoms (such as swelling, stiffness, and range of motion) (7 items) * Function in Daily Living (ADL) (17 items) * Function in Sport and Recreation (Sport/Rec) (5 items) * Knee-Related Quality of Life (QOL) (4 items Scoring * Format: Patients rate each item using a 5-point Likert scale (from 0 to 4) based on their experiences over the preceding week. * Scale: Each subscale is calculated independently and transformed to a 0 to 100 scale. * Interpretation: * 0 represents extreme knee problems / total disability. * 100 represents no knee problems / perfect joint health. * No Total Score: An aggregate or single total score is not calculated
Time frame: from enrollment till 12 months post-operative
Clinical improvement by AKPS Functional knee score
Validated knee scoring systems will be recorded preoperatively and during follow-up by Kujala Anterior Knee Pain Scale (AKPS) The AKPS is a 13-item, patient-reported questionnaire used to evaluate subjective symptoms and functional limitations in people with patellofemoral disorders Overview of the Scale * Total Score Range: 0 to 100 points * Interpretation: * 85-100: Near-normal / minimal dysfunction (Excellent) * 70-84: Mild dysfunction (Scores around 70 often reflect moderate disability) * 50-69: Moderate patellofemoral dysfunction (Fair) * 0-49: Severe patellofemoral dysfunction with significant pain and limitations (Poor)
Time frame: from enrollment till 12 months post-operative
Mechanical axis correction
The invistigators aim for HKA angle at approximately 0°
Time frame: from enrollment till 12 months post-operative
No study locations are listed for this record.
Plan to share: Undecided
Start is estimated for Nov 2026; primary completion for Nov 2028, 23 months later.
Of 578 non-industry interventional studies with no phase under Osteoarthritis, half reached primary completion within 26 months of starting (the median), counting those still running; a quarter within 10 and three quarters within 52. This study's planned 23 months is below that.
Counting every sponsor, half of 713 studies reached it within 29 months; a quarter within 11 and three quarters within 58.
How these figures are worked out, and which studies are left out of them.
From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
This study is not yet recruiting, as verified in Oct 2026. You cannot join it, but the record below documents what was studied.
Get an email when the registry record changes — status, dates, results — or when someone posts here.
Sign in to followQuestions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.
Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.
Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.