| Objective:Using a three-dimensional gait analysis system,to investigate the kinematics and dynamics of open wedge high tibial osteotomy in the treatment of varus deformity,which can be used to evaluate the clinical efficacy.Methods: In the Department of sports medicine of Zhong Shan Hospital Affiliated with Dalian University,from January 2015 to june 2017,there were 54 patients with Medial single compartment osteoarthritis combined genu varus.There were 24 males,with an average age of(52.5 ± 4.7)years,with a height of(1.7 ± 0.2)meter and an average weight of(75.3 ± 9.1)kg.There were 30 females,with an average age of(56.2 ± 4.4)years,with a height of(1.6 ± 0.1)meter and an average weight of(54.1 ± 3.1)kg.Both arthroscopy and open wedge high tibial osteotomy were performed.During the operation,orthopedic anatomical plates were used to fix the osteotomy space.The domestic independent research and development of the eastern xinrui DVMC 8801 3D gait capture is taken,and the non-invasive kinematic observation of the patients is carried out under the infrared system.Every 120 seconds the motion data acquisition measurement requirements is relatively stable,constant speed(1.6km/h).Recorded during walking,the flexion and extension angle,the angle of the knee joint and the angle of internal and external rotation were recorded in preopration and postopration 3,6,9 and 12 months,and the gait data were analyzed and compared in order to evaluate the effect of the high tibial osteotomy on the gait correction ofthe knee varus.Measuring the relative position of the mechanical axis of the lower extremities through the tibial plateau,femoral tibial angle(FTA),the Medial angle of proximal tibia(MPTA),the posterior slope angle of medial tibial plateau and Patellar height(Insall-Salvati)in peroperation and postoperation 3,6,9 and 12 months,And hospital for special Surgery knee score(HSS)were used to evaluate the curative effect of surgery.Results: Subjects were followed up for 12 months or more success.In the gait cycle,the flexion and extension angles of the KOA limb were-2 ~41 degrees,the internal and external turning angle were-10 ~20 degrees,the internal and external rotation angle were-11 ~14 degrees.Three months after the Medial open wedge high tibial osteotomy the flexion and extension angles were-3 ~47 degrees,the internal and external turning angle were-10 ~10 degrees,the internal and external rotation angle were-6 ~9 degrees;Six months after postoperation the flexion and extension angles were-3 ~53 degrees,the internal and external turning angle were-7 ~9 degrees,the internal and external rotation angle were-5 ~9 degrees;Nine months after postoperation the flexion and extension angles were-2 ~60 degrees,the internal and external turning angle were-5 ~8 degrees,the internal and external rotation angle were-2 ~9 degrees;Twelve months after postoperation the flexion and extension angles were-2 ~63 degrees,the internal and external turning angle were-4 ~8 degrees,the internal and external rotation angle were-2 ~8 degrees.The angle of flexion and extension of normal knee joint is-3 ~65 degrees,the internal and external turning angle were-5 ~9 degrees,the internal and external rotation angle were-5 ~10 degrees.Compared with the healthy limb,the knee flexion and extension angles of the KOA patients were smaller,while the internal and external rotation angles and internal and external rotation angles increased significantly(P< 0.05).The knee flexion and extension,the internal and external rotation and the internal and external rotation were improved more and more obviously than the normal at the 4 follow-up time points after the reconstruction,and the knee flexion was higher than the preoperation,and The gait data of 6 months and 9 monthsafter osteotomy were closer to the normal gait,and the gait of the 12 months after the operation was not significantly different from that of the normal,but the knee joint movement angle was obviously improved compared with the preoperative and 3 months after the operation,which was statistically significant(P < 0.05),but there was no significant difference compared with the contralateral limb,suggesting that the average recovery of 6 months after osteotomy was close to the normal level.Imaging changes were not obvious within 12 months after operation,and the knee HSS score increased with rehabilitation time.Comparison between preoperative and 12 months postoperatively,the relative position of the mechanical axis of the lower extremities through the tibial plateau changed from(19.8 ± 15.1)% to(54.8 ± 3.6)%,The femoral tibial angle was reduced from(183.3± 1.2)degrees to(173.2 ± 1.2)degrees,the medial angle of proximal tibia was improved from(80.4 ± 3.5)degrees to(88.3 ± 1.5)degrees before operation,the posterior slope angle of medial tibial plateau increased from(10.2 ± 3.1)degrees to(14.7 ± 5.1)degrees,The height of patella was reduced from(1.16 ± 0.25)to postoperative(1.01 ± 0.17),and the knee joint HSS score was improved from(64.3± 3.8)to(91.6 ± 3.5),and the difference was statistically significant(P<0.05).Conclusion: A three-dimensional motion capture system is used to evaluate the function of the patients with medial compartment osteoarthritis and the changes of gait after osteotomy.It is a good evaluation method.The results show that the osteotomy can improve the function of the joint,improve the stability of the knee joint,and improve the HSS knee joint function score.As time went on,the HSS knee function score increased gradually within 12 months after operation.6 months after the tibial high osteotomy,the knee gait approached the normal gait,while at least 9 months gait had no significant difference from normal.The quantitative data obtained by the analysis provide an objective basis for the diagnosis,clinical treatment and evaluation of the curative effect of KOA combined with knee varus,and it is worthy of clinical application andpopularization. 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