Comparison of the Functional and Radiological Outcomes of Single- and Two-Stage Bilateral Open Wedge High Tibial Osteotomy

Abstract Purpose This study compared the functional and radiological outcomes and complications of single- (SS) and two-stage (TS) bilateral high tibial osteotomy (HTO). Methods From 2014 to 2018, 48 patients underwent bilateral HTO surgery for osteoarthritis. The outcomes of SS in 28 knees and TS in 32 knees were compared using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and Oxford Knee Score (OKS) as functional outcomes, and the medial proximal tibial (MPTA), hip-knee-ankle (HKA), tibial slope (TSA) angles, and mechanical axis deviation (MAD) as radiological outcomes. We also evaluated the estimated blood loss (EBL). Results No significant differences in the pre- and postoperative mean OKS and KOOS were found between the groups. There was a significant difference between the groups in the last postoperative HKA angle (− 0.9 ± 3.9 and 1.8 ± 4.3°, respectively). In SS and TS, the respective total mean surgical time was 108 ± 28 and 143 ± 36 min (p < 0.001). The mean calculated EBL was 612 ± 267 and 544 ± 357 mL, respectively, (p = 0.5), and the mean length of stay (LOS) was 2.2 ± 0.83 and 3.5 ± 1.0 days, respectively, (p = 0.01). Conclusion SS bilateral HTO is a safe reasonable option for certain patients with bilateral knee osteoarthritis because it involves a single hospitalization, one-time exposure to anesthesia risks, accelerated rehabilitation, earlier return to expected life status, reduced total hospital stay, and a likely decrease in total cost.

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Patellar height is not modified after isolated open-wedge high tibial osteotomy without change in posterior tibial slope

Orthopaedics & Traumatology Surgery & Research ◽

10.1016/j.otsr.2021.103032 ◽

2021 ◽

pp. 103032

Author(s):

Mathieu Carissimi ◽

Pierre Sautet ◽

Dimitri Charre ◽

Lukas Hanak ◽

Matthieu Ollivier ◽

...

Keyword(s):

High Tibial Osteotomy ◽

Tibial Slope ◽

Patellar Height ◽

Posterior Tibial Slope ◽

Tibial Osteotomy ◽

Open Wedge ◽

Posterior Tibial ◽

Wedge High Tibial Osteotomy

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Effect of the Osteotomy Length on the Change of the Posterior Tibial Slope With a Simple Distraction of the Posterior Gap in the Uni- and Biplanar Open-Wedge High Tibial Osteotomy

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2015.07.018 ◽

2016 ◽

Vol 32 (2) ◽

pp. 263-271 ◽

Cited By ~ 11

Author(s):

Yong Seuk Lee ◽

Jong Yeal Kang ◽

Myung Chul Lee ◽

Won Seok Oh ◽

Ashraf Elazab ◽

...

Keyword(s):

High Tibial Osteotomy ◽

Tibial Slope ◽

Posterior Tibial Slope ◽

Tibial Osteotomy ◽

Open Wedge ◽

Posterior Tibial ◽

Wedge High Tibial Osteotomy

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EVALUATION OF OUTCOME OF MEDIAL OPENING WEDGE HIGH TIBIAL OSTEOTOMY FOR UNICOMPARTMENTAL KNEE OSTEOARTHRITIS

10.36106/ijsr/2404839 ◽

2020 ◽

pp. 1-4

Author(s):

R. N. Shewale ◽

Ketan J. Khatri

Keyword(s):

Knee Osteoarthritis ◽

Functional Outcome ◽

High Tibial Osteotomy ◽

Medial Compartment ◽

Functional Score ◽

Tibial Osteotomy ◽

Knee Score ◽

Opening Wedge ◽

Wedge High Tibial Osteotomy ◽

The Mean

Background: Osteoarthritis is often found in weight-bearing joints, the knee being the most common site. Most patients of symptomatic osteoarthritis of knee are associated with varus malalignment that is causative or contributory to painful arthritis. Correcting the malalignment of the knee relieves symptoms by transferring the functional load to the unaffected compartment. The goal of the treatment is to relieve medial compartment knee pain and slow down the arthritic progression. We report the outcome of a simple technique of medial opening wedge high tibial osteotomy in treating the medial compartment osteoarthritis of the knee. Materials and method: A prospective interventional study was carried out over a period of 2 years from November 2017 to October 2019 in a sample size of randomly selected 41 patients having unilateral knee osteoarthritis. All patients after a proper preoperative assessment underwent high tibial osteotomy and the outcome was evaluated using knee society scoring system. Results: The age of the patients ranged from 40 – 65 years with a mean age of 51 years, 13 were males and 28 were females showing female predominance (68.2%). The mean knee score and the mean functional score of the patients before surgery were 60 and 61.95 respectively and post operatively at the end of 6 months the knee score and functional score was 77 and 80.53 respectively. By the end of 6 months out of 41 patients, 12 patients (29.2%) had excellent functional outcome, 18 patients (43.90%) had good functional outcome, 09 patients (21.95%) had fair functional outcome while only 02 patients (04.87%) had poor functional outcome. Conclusions: The present study shows that HTO is a good option in isolated medial compartment OA of knee. Significant increase in the knee score and functional score was found after high tibial osteotomy for the patients of osteoarthritis with varus deformity. Success of high tibial osteotomy relies on appropriate patient selection, proper osteotomy type and precise surgical technique.

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Second-look arthroscopic cartilage status is related to intermediate-term outcomes after medial opening-wedge high tibial osteotomy

The Bone & Joint Journal ◽

10.1302/0301-620x.103b11.bjj-2020-2130.r2 ◽

2021 ◽

Vol 103-B (11) ◽

pp. 1686-1694

Author(s):

Hong-Yeol Yang ◽

Woo-Kyoung Kwak ◽

Sung Ju Kang ◽

Eun-Kyoo Song ◽

Jong-Keun Seon

Keyword(s):

Clinical Outcomes ◽

High Tibial Osteotomy ◽

Cartilage Repair ◽

Tibial Osteotomy ◽

Opening Wedge ◽

Status Group ◽

Second Look ◽

Wedge High Tibial Osteotomy ◽

The Mean

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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