Return to sport outcomes after inverted V-shaped (IV) high tibial osteotomy were comparable to those after medial opening-wedge high tibial osteotomy, even though the IV cohort had more severe preoperative disease.

PURPOSE: The primary aim was to compare return to sport (RTS) outcomes following inverted V-shaped high tibial osteotomy (IV-HTO) versus medial opening-wedge (OW)-HTO for medial knee osteoarthritis (OA). The secondary aim was to compare patient-reported outcomes and radiographic parameters between the procedures. METHODS: This retrospective cohort study included patients who underwent HTO for medial knee OA between 2017 and 2022. Inclusion criteria were preoperative sports participation and 2-year follow-up. Patients were allocated to IV-HTO (IV group) or OW-HTO (OW group) according to indications based on the planned correction angle and patellofemoral OA grade. Outcomes were assessed preoperatively and at 2 years. Between-group comparisons used appropriate parametric/nonparametric tests, with RESULTS: A total of 107 patients were analysed (IV group: 54 patients; OW group: 53 patients). Mean age was 58.4 years, body mass index (BMI) 25.6 kg/m CONCLUSIONS: IV-HTO achieved RTS and patient-reported outcomes comparable to OW-HTO at 2 years in patients with more severe preoperative disease. LEVEL OF EVIDENCE: Level III, retrospective comparative study.