| Summary: | Abstract Objective This retrospective study aimed to conduct a comparative analysis of the impact of high tibial osteotomy (HTO) and supramalleolar osteotomy (SMOT) on lower limb alignment and ankle function after surgery. Methods A cohort of patients who underwent either HTO (n = 63) or SMOT (n = 51) for lower limb alignment issues was included in the study. Inclusion criteria comprised individuals who underwent the surgical procedures between June 2018 and June 2021; exclusion criteria encompassed incomplete medical records and inadequate follow-up data. Baseline characteristics, weight-bearing line ratios, ankle joint function, and lower limb lines of force were evaluated before surgery, postoperatively, and at the 6-month follow-up. Statistical analyses were performed to compare the outcomes between the HTO and SMOT groups, as well as between non-deviated and deviated subgroups. Spearman rank correlation analysis was used to reveal correlations between variables. Results The preoperative and immediate postoperative weight-bearing line ratios were similar between the HTO and SMOT groups. However, a notable difference emerged at the 6-month follow-up, suggesting distinct impacts of the two procedures on lower limb alignment. Additionally, the HTO group exhibited superior postoperative outcomes in ankle joint function, specifically in pain alleviation and functional improvement, compared to the SMOT group. The analysis of lower limb lines of force demonstrated a significant association between the surgical procedure and alterations in lower limb biomechanics, emphasizing the differential impact of HTO and SMOT. Furthermore, the comparison between non-deviated and deviated subgroups highlighted the potential impact of lower limb alignment on postoperative ankle function. Conclusion The findings contribute valuable insights into the comparative effectiveness of HTO and SMOT in addressing lower limb alignment and ankle function. This study’s results have significant implications for orthopedic treatment and may guide treatment strategies for patients undergoing lower limb realignment surgery, ultimately enhancing the quality of life for affected individuals.
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