High Tibial Osteotomy (HTO), Unicompartmental Knee Arthroplasty (UKA), and Proximal Fibular Osteotomy (PFO) for Medial-Compartment Knee Osteoarthritis: A Narrative Review of Comparative Mechanisms, Clinical Outcomes, and Decision-Making.

ABSTRACT: Background: Medial-compartment knee osteoarthritis with varus alignment is treated surgically by realignment (high tibial osteotomy, HTO), resurfacing (unicompartmental knee arthroplasty, UKA), or proximal fibular osteotomy (PFO), which aims to indirectly unload the medial tibial plateau. Methods: We conducted a structured narrative review (PubMed/MEDLINE, Google Scholar; 2000-2025; last search 30 August 2025) of comparative clinical, biomechanical and safety data for HTO, UKA and PFO, including prior meta-analyses and mechanistic reports. One hundred fourteen studies met prespecified criteria. Results: HTO reliably corrects coronal alignment and unloads the medial compartment; long-term survivorship varies by selection and technique, and complications include hinge fr

SUBMITTER: Yapıcı F 

PROVIDER: S-EPMC12608725 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature