| Summary: | Knee osteoarthrosis (OA) is a widespread orthopedic problem and a high tibial osteotomy (HTO) is a common treatment to minimize degeneration of the affected compartment. The primary aim of this study was to evaluate the postural regulation and stability among patients who underwent HTO and rehabilitation. This prospective study included 32 patients (55.3 ± 5.57 years) diagnosed with medial tibiofemoral OA. Each subject completed postural regulation and stability testing (Interactive Balance System), as well as pain intensity (visual analogue scale) and quality of life questionnaires (SF-36) prior to HTO (exam 1), and at six weeks (exam 2), twelve weeks (exam 3) and six months (exam 4) post HTO. For postural comparison, all patients were matched (sex, age, height) with asymptomatic subjects. Significant time effects (exam 1 vs. exam 4) were found for weight distribution index (WDI; η<sub>p</sub><sup>2</sup> = 0.152), mediolateral weight distribution η<sub>p</sub><sup>2</sup> = 0.163) and anterior–posterior weight distribution η<sub>p</sub><sup>2</sup> = 0.131). The largest difference (exam 3: η<sub>p</sub><sup>2</sup> = 0.251) and the most significant differences to the matched sample were calculated for the stability indicator (exam 1: η<sub>p</sub><sup>2</sup> = 0.237; exam 2: η<sub>p</sub><sup>2</sup> = 0.215; exam 3: η<sub>p</sub><sup>2</sup> = 0.251; exam 4: η<sub>p</sub><sup>2</sup> = 0.229). Pain intensity showed a significant reduction (η<sub>p</sub><sup>2</sup> = 0.438) from exam 1 (50.7 ± 20.0 mm) to exam 4 (19.3 ± 16.0 mm). Physical pain was the quality of life parameter with the largest improvement between exams 1 and 4 (η<sub>p</sub><sup>2</sup> = 0.560). HTO allows patients to improve their mediolateral weight distribution, whereas postural stability is consistently lower than in asymptomatic subjects. This surgery leads to marked improvements in quality of life and pain.
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