Correction to: Decision making for concomitant high tibial osteotomy (HTO) in cartilage repair patients based on a nationwide cohort study of 4968 patients

Aims To determine the relationship between articular cartilage status and clinical outcomes after medial opening-wedge high tibial osteotomy (MOHTO) for medial compartmental knee osteoarthritis at intermediate follow-up. Methods We reviewed 155 patients (155 knees) who underwent MOHTO from January 2008 to December 2016 followed by second-look arthroscopy with a mean 5.3-year follow-up (2.0 to 11.7). Arthroscopic findings were assessed according to the International Cartilage Repair Society (ICRS) Cartilage Repair Assessment (CRA) grading system. Patients were divided into two groups based on the presence of normal or nearly normal quality cartilage in the medial femoral condyle: good (second-look arthroscopic) status (ICRS grade I or II; n = 70), and poor (second-look arthroscopic) status (ICRS grade III or IV; n = 85) groups at the time of second-look arthroscopy. Clinical outcomes were assessed using the International Knee Documentation Committee (IKDC) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and 36-Item Short Form survey. Results Significant improvements in all clinical outcome categories were found between the preoperative and second-look arthroscopic assessments in both groups (p < 0.001). At the latest follow-up, the mean IKDC and WOMAC scores in the good status group further improved compared with those at the time of second-look arthroscopic surgery (p < 0.001), which was not shown in the poor status group. The mean IKDC (good status, 72.8 (SD 12.5); poor status, 64.7 (SD 12.1); p = 0.002) and mean WOMAC scores (good status, 15.7 (SD 10.8); poor status, 21.8 (SD 13.6); p = 0.004) significantly differed between both groups at the latest follow-up. Moreover, significant correlations were observed between ICRS CRA grades and IKDC scores (negative correlation; p < 0.001) and WOMAC scores (positive correlation; p < 0.001) at the latest follow-up. Good cartilage status was found more frequently in knees with the desired range of 2° to 6° valgus correction than in those with corrections outside this range (p = 0.019). Conclusion Second-look arthroscopic cartilage status correlated with clinical outcomes after MOHTO at intermediate-term follow-up, despite the relatively small clinical differences between groups. Cite this article: Bone Joint J 2021;103-B(11):1686–1694.

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High Tibial Osteotomy in Posterior Cruciate Ligament Posterolateral Instability: Decision Making and Surgical Technique

Operative Techniques in Sports Medicine ◽

10.1053/j.otsm.2015.08.004 ◽

2015 ◽

Vol 23 (4) ◽

pp. 338-347

Author(s):

Daniel Whelan ◽

Matthew Gunton

Keyword(s):

Decision Making ◽

Surgical Technique ◽

Posterior Cruciate Ligament ◽

High Tibial Osteotomy ◽

Cruciate Ligament ◽

Tibial Osteotomy ◽

Posterolateral Instability

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Bovine xenograft locking Puddu plate versus tricalcium phosphate spacer non-locking Puddu plate in opening-wedge high tibial osteotomy: a prospective double-cohort study

International Orthopaedics ◽

10.1007/s00264-013-1817-5 ◽

2013 ◽

Vol 37 (5) ◽

pp. 819-826 ◽

Cited By ~ 19

Author(s):

Nicola Maffulli ◽

Mattia Loppini ◽

Umile Giuseppe Longo ◽

Vincenzo Denaro ◽

Francesco Oliva

Keyword(s):

Cohort Study ◽

High Tibial Osteotomy ◽

Tricalcium Phosphate ◽

Plate Versus ◽

Tibial Osteotomy ◽

Opening Wedge ◽

Puddu Plate ◽

Wedge High Tibial Osteotomy ◽

Bovine Xenograft

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High tibial osteotomy: A review of the readability and quality of patient information on the internet

Health Promotion Perspectives ◽

10.34172/hpp.2021.41 ◽

2021 ◽

Vol 11 (3) ◽

pp. 323-328

Author(s):

Matthew Clark ◽

Ian Colin Baxter ◽

Matthew Hampton ◽

Robert D Sandler ◽

Andrew Legg

Keyword(s):

Decision Making ◽

High Tibial Osteotomy ◽

Patient Information ◽

Code Of Conduct ◽

The Internet ◽

Online Information ◽

Tibial Osteotomy ◽

Common Procedure ◽

Flesch Reading Ease

Background: High tibial osteotomy (HTO) is a common procedure performed for unicompartmental knee osteoarthritis (OA). Patients are increasingly using the internet to research surgical procedures to help aid decision making. Our aim was to assess the readability and quality of information available to patients online relating to HTO. Methods: A systematic review of three search engines Google, Bing, and Yahoo using the search terms "high tibial osteotomy" and "tibial osteotomy" separately was performed. The first three pages of results for each search engine were analyzed. Readability was assessed using the Flesch Reading Ease Scale (FRES), Flesch-Kincaid Grade level (FKGL) and the Simple Measure of Gobbledygook formula (SMOG). Quality was assessed with the DISCERN questionnaire, JAMAbenchmarks and the presence of Health on the Net Foundation Code of Conduct (HONCode). Results: Twenty-four webpages were included after duplicates (n=42) and exclusions (n=24).The overall readability was low, with a mean FRES of 53.2 (SD: 9.1), FKGL 10.7 (SD: 1.8),SMOG 10.4 (SD: 1.5). Quality was also low with a mean DISCERN score of 42 (SD: 12.3).None of the webpages fulfilled all of the JAMA benchmarking criteria and only 2/24 (8.3%)webpages possessed HONCode certification. Conclusion: The overall online information available to patient’s considering HTO is of lowreadability and quality. Improving the quality and readability of patient information online willbenefit informed patient decision making before HTO surgery.

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Reduced survival of total knee arthroplasty after previous unicompartmental knee arthroplasty compared with previous high tibial osteotomy: a propensity-score weighted mid-term cohort study based on 2,133 observations from the Danish Knee Arthroplasty Registry

Acta Orthopaedica ◽

10.1080/17453674.2019.1709711 ◽

2020 ◽

Vol 91 (2) ◽

pp. 177-183 ◽

Cited By ~ 2

Author(s):

Anders El-Galaly ◽

Poul T Nielsen ◽

Andreas Kappel ◽

Steen L Jensen

Keyword(s):

Total Knee Arthroplasty ◽

Cohort Study ◽

Propensity Score ◽

High Tibial Osteotomy ◽

Knee Arthroplasty ◽

Unicompartmental Knee Arthroplasty ◽

Tibial Osteotomy ◽

Unicompartmental Knee ◽

Arthroplasty Registry ◽

Total Knee

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Effectiveness of High Tibial Osteotomy with or without Other Procedures for Medial Compartment Osteoarthritis of Knee: An Update Meta-Analysis

The Journal of Knee Surgery ◽

10.1055/s-0039-1700978 ◽

2020 ◽

Cited By ~ 4

Author(s):

Ru-Zhan Yao ◽

Wei-Qiang Liu ◽

Liang-Zhi Sun ◽

Ming-Dong Yu ◽

Guang-Lin Wang

Keyword(s):

Pain Relief ◽

Clinical Outcomes ◽

High Tibial Osteotomy ◽

Cartilage Repair ◽

Meta Analysis ◽

Mean Difference ◽

Control Group ◽

Tibial Osteotomy ◽

Beneficial Effects ◽

Magnetic Resonance Imaging Mri

AbstractTo improve the long-term outcomes of high tibial osteotomy (HTO) for gonarthritis, many cartilage repair procedures appeared, but their effects were controversial. To evaluate the efficacy of cartilage repair procedures during HTO for gonarthritis, we performed this update meta-analysis. We performed the system retrieval for clinical trials using various databases and then pooled the outcomes of the included studies. Fifteen studies were involved. The pooled results indicated that there were no significant differences in Kellgren and Lawrence (KL) scale (mean difference [MD] = 0.02, 95% confidence interval [CI] = −0.01 to 0.06, p = 0.24), the femorotibial angle (MD = 0.06, 95% CI = −0.04 to 0.16, p = 0.22), and magnetic resonance imaging (MRI) outcomes (MD = 12.53, 95% CI = −2.26 to 27.32, p = 0.10) of patients in experimental group than control. The subgroup analysis showed that the clinical outcomes of abrasion arthroplasty (AA) were worse than control group (standardized mean difference [SMD] −2.65, 95% CI = −3.67 to −1.63, p < 0.001), while mesenchymal stem cells (MSCs) injection improved the clinical outcomes (SMD = 2.37, 95% CI = 1.25–3.50, p < 0.001). There were significant differences between the two groups in arthroscopic (SMD = 1.38, 95% CI = 0.82–1.94, p < 0.001) and histologic results (relative risk [RR] = 1.77, 95% CI = 1.36–2.29, p < 0.001). The pain relief (MD = 0.17, 95% CI = −3.26 to 3.61, p = 0.92) and operative complications (RR = 1.42, 95% CI = 0.83–2.42; p = 0.19) of the two groups had no significant differences. Our analysis supports that concurrent cartilage repair procedures might improve arthroscopic and histologic outcomes, but they have no beneficial effect on clinical outcomes, radiograph, MRI, and pain relief. The concurrent procedures do not increase the risk of operative complication. Furthermore, MSC has some beneficial effects on clinical outcomes, while AA might play an opposite role.

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