The lateral closing and medial opening wedge high tibial osteotomy can correct a varus malalignment of the knee caused by medial compartment osteoarthritis. These procedures have produced great short-term and mid-term results. As no systematic review has examined their long-term results yet, the goal of this article was to compare the results of all articles about lateral closing and medial opening wedge high tibial osteotomies, published after the year 2000, with a mean follow-up of more than 10 years. A systematic search of the Medline, Web of Science and Cochrane databases resulted in the inclusion of 30 articles. All these studies combined examined the results of 7087 high tibial osteotomies in a total of 6636 patients after a mean follow-up of more than 10 years. Primary outcome measures were the survival rate of the osteotomy, functional scores, patient satisfaction and pain scores. Secondary outcome measures were alignment correction and the identification of factors influencing the survival of the osteotomy. The 5-year, 10-year, 15-year and 20-year survival rates, respectively, ranged from 86 to 100%, 64–97.6%, 44–93.2% and 46–85.1%. The subjective scoring systems showed an improvement postoperatively that was maintained until final follow-up. The anatomical and mechanical tibiofemoral axis were, respectively, corrected to a mean of 7.3°–13.8° of valgus and 0.6°–4° of valgus. The results of the articles evaluating the influence of potential risk factors were contradictory. Despite the low quality of the available evidence, the lateral closing and medial opening wedge high tibial osteotomy seem to remain valid long-term treatment options for patients with painful varus malalignment caused by isolated medial compartment osteoarthritis of the knee. The available results indicate that the need for arthroplasty could be delayed for more than 15 years in the majority of patients. However, higher-quality studies are needed to confirm these findings. As a systematic review is assigned a level of evidence equivalent to the lowest level of evidence used from the analyzed manuscripts, the level of evidence of this systematic review is IV.

外侧闭合和内侧开口楔形胫骨高位截骨术可以纠正内侧间室骨关节炎引起的膝关节内翻错位。这些程序产生了很好的短期和中期结果。由于尚未对其长期结果进行系统评价，本文的目的是比较 2000 年后发表的所有关于外侧闭合和内侧开口楔形胫骨高位截骨术的结果，平均随访时间为超过 10 年。对 Medline、Web of Science 和 Cochrane 数据库进行系统搜索，结果包含 30 篇文章。所有这些研究在平均随访 10 年以上后，对总共 6636 名患者的 7087 次胫骨高位截骨术的结果进行了检查。主要结果指标是截骨术的存活率，功能评分、患者满意度和疼痛评分。次要结果测量是对齐校正和确定影响截骨术存活率的因素。5年、10年、15年和20年生存率分别为86%～100%、64%～97.6%、44%～93.2%和46%～85.1%。主观评分系统显示术后改善一直持续到最终随访。解剖和机械胫股骨轴分别校正为平均外翻 7.3°–13.8° 和 0.6°–4° 外翻。评估潜在风险因素影响的文章的结果相互矛盾。尽管现有证据的质量很低，外侧闭合和内侧开口楔形胫骨高位截骨术似乎仍然是治疗由孤立的膝关节内侧间室骨关节炎引起的疼痛性内翻畸形患者的有效长期治疗选择。现有结果表明，大多数患者需要进行关节置换术的时间可能会推迟 15 年以上。然而，需要更高质量的研究来证实这些发现。由于系统评价的证据级别相当于所分析的手稿中使用的最低级别的证据，因此该系统评价的证据级别为 IV。需要更高质量的研究来证实这些发现。由于系统评价的证据级别相当于所分析的手稿中使用的最低级别的证据，因此该系统评价的证据级别为 IV。需要更高质量的研究来证实这些发现。由于系统评价的证据级别相当于所分析的手稿中使用的最低级别的证据，因此该系统评价的证据级别为 IV。