Medial Opening Wedge Osteotomy for Early Osteoarthritis of the Knee With Dr. Saigal's Plate: A Case Report With Review of Literature
Bibliographic record
Abstract
Knee pain in patients often involves varus deformity and unicompartmental osteoarthritis (OA). High tibial valgus osteotomy (HTO) is increasingly recognized as an effective treatment, as it realigns the knee's mechanical axis towards the healthier lateral compartment, delaying degenerative changes in the medial compartment and reducing the need for joint replacement. This case report discusses two patients with bilateral knee arthritis and varus deformity who underwent medial opening-wedge high tibial osteotomy (MOWHTO) using Dr. Saigal's plate (Nebula Surgical Pvt. Ltd., Gujarat, India). The first patient, a 45-year-old male with a BMI of 29.3 kg/m², had a good range of motion (ROM) and no ligamentous laxity. The second patient, a 36-year-old female with a BMI of 30 kg/m², also exhibited good knee ROM and no ligamentous laxity. Initial evaluation included comprehensive radiological assessments via four X-rays: anteroposterior (AP) view in 30-degree flexion, lateral view, skyline view for the patellofemoral joint, and a standing orthosonogram view from the hip to the toes. The surgical technique aimed to correct varus angulation with valgus overcorrection. Preoperative preparation followed the Miniaci Method, involving a weight-bearing AP orthoscan of the entire leg to determine the corrective angle. Postoperatively, a protocol focused on fixation rigidity allowed toe-touch walking after six weeks. Suture removal occurred on the 14th day with no NSAIDs administered. Data were collected preoperatively, intraoperatively, and at three, six, and twelve months postoperatively. Primary outcomes included the Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and ROM. Secondary measures assessed mechanical axis deviation (MAD), correction of varus angulation, pain levels, and complications using the Modified RUST criteria for osteotomy site evaluation. At the final follow-up, both patients showed excellent clinical outcomes with pain-free joint motion and optimal limb alignment. No complications such as infection, hardware failure, or need for total knee replacement were reported. The mean preoperative OKS significantly improved, indicating the procedure's effectiveness in enhancing function and quality of life. The WOMAC pain and functional subscores also improved consistently over the year. Although there was a temporary decrease in knee ROM initially, it rebounded by the final assessments. Overall, the intervention was safe and successful, with no deep infections, deep vein thrombosis, lateral hinge fractures, varus collapse, or implant failures reported.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.005 | 0.004 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".