Skip to main content
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 1/2013

01.01.2013 | Knee

Return to work and clinical outcome after open wedge HTO

verfasst von: Steffen Schröter, Johannes Mueller, Ronald van Heerwaarden, Philipp Lobenhoffer, Ulrich Stöckle, Dirk Albrecht

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 1/2013

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The purpose of this study was to examine the incapacity of work related to work load according to the classification that has been introduced by the REFA Association and the clinical outcome after open wedge HTO with autologous bone graft from the iliac crest.

Methods

A total of 32 patients who were employed and able to work at the time of the surgery as well as treated with an open wedge HTO with the LC-DCP and autologous bone wedges from the iliac crest could be included in the radiological and clinical examination (77 months, SD ± 19). Postoperative duration of the incapacity of work and subjective ratings were based on the information provided by the patients themselves. The German classification that has been established by the REFA Association was used to classify the work load. Several clinical scores were used for clinical assessment.

Results

The duration of incapacity of work (median, 87 days; range, 14–450) demonstrated a relation to work load according to REFA. The Lysholm score, the HSS score and the score according to Lequesne augmented by 19.2 ± 16.8 (p < 0.0001), 15.6 ± 13.2 (p < 0.0001) and −6.0 ± 5.1 (p < 0.0001), respectively. The Tegner score gained from median 3 (range, 1–5) to 4 (range, 1–8).

Conclusion

In this study, a relation was found between work load divided into different categories according to the classification established by the REFA Association and the duration of incapacity of work after open wedge HTO. An improvement of all clinical scores was observed. Typical neurological complications after autologous bone transplantation from the iliac crest were observed in 19 % of our patient population.

Level of evidence

IV.
Literatur
1.
Zurück zum Zitat Aglietti P, Buzzi R, Vena LM, Baldini A, Mondaini A (2003) High tibial valgus osteotomy for medial gonarthrosis: a 10- to 21-year study. J Knee Surg 16(1):21–26PubMed Aglietti P, Buzzi R, Vena LM, Baldini A, Mondaini A (2003) High tibial valgus osteotomy for medial gonarthrosis: a 10- to 21-year study. J Knee Surg 16(1):21–26PubMed
2.
Zurück zum Zitat Ahlmann E, Patzakis M, Roidis N, Shepherd L, Holtom P (2002) Comparison of anterior and posterior iliac crest bone grafts in terms of harvest-site morbidity and functional outcomes. J Bone Joint Surg Am 84-A(5):716–720PubMed Ahlmann E, Patzakis M, Roidis N, Shepherd L, Holtom P (2002) Comparison of anterior and posterior iliac crest bone grafts in terms of harvest-site morbidity and functional outcomes. J Bone Joint Surg Am 84-A(5):716–720PubMed
3.
Zurück zum Zitat Akizuki S, Shibakawa A, Takizawa T, Yamazaki I, Horiuchi H (2008) The long-term outcome of high tibial osteotomy: a ten- to 20-year follow-up. J Bone Joint Surg Br 90(5):592–596PubMedCrossRef Akizuki S, Shibakawa A, Takizawa T, Yamazaki I, Horiuchi H (2008) The long-term outcome of high tibial osteotomy: a ten- to 20-year follow-up. J Bone Joint Surg Br 90(5):592–596PubMedCrossRef
4.
Zurück zum Zitat Amendola A, Fowler PJ, Litchfield R, Kirkley S, Clatworthy M (2004) Opening wedge high tibial osteotomy using a novel technique: early results and complications. J Knee Surg 17(3):164–169PubMed Amendola A, Fowler PJ, Litchfield R, Kirkley S, Clatworthy M (2004) Opening wedge high tibial osteotomy using a novel technique: early results and complications. J Knee Surg 17(3):164–169PubMed
5.
Zurück zum Zitat Asik M, Sen C, Kilic B, Goksan SB, Ciftci F, Taser OF (2006) High tibial osteotomy with Puddu plate for the treatment of varus gonarthrosis. Knee Surg Sports Traumatol Arthrosc 14(10):948–954PubMedCrossRef Asik M, Sen C, Kilic B, Goksan SB, Ciftci F, Taser OF (2006) High tibial osteotomy with Puddu plate for the treatment of varus gonarthrosis. Knee Surg Sports Traumatol Arthrosc 14(10):948–954PubMedCrossRef
6.
Zurück zum Zitat Briem K, Ramsey DK, Newcomb W, Rudolph KS, Snyder-Mackler L (2007) Effects of the amount of valgus correction for medial compartment knee osteoarthritis on clinical outcome, knee kinetics and muscle co-contraction after opening wedge high tibial osteotomy. J Orthop Res 25(3):311–318PubMedCrossRef Briem K, Ramsey DK, Newcomb W, Rudolph KS, Snyder-Mackler L (2007) Effects of the amount of valgus correction for medial compartment knee osteoarthritis on clinical outcome, knee kinetics and muscle co-contraction after opening wedge high tibial osteotomy. J Orthop Res 25(3):311–318PubMedCrossRef
7.
Zurück zum Zitat Brinkman JM, Luites JW, Wymenga AB, van Heerwaarden RJ (2010) Early full weight bearing is safe in open-wedge high tibial osteotomy. Acta Orthop 81(2):193–198PubMedCrossRef Brinkman JM, Luites JW, Wymenga AB, van Heerwaarden RJ (2010) Early full weight bearing is safe in open-wedge high tibial osteotomy. Acta Orthop 81(2):193–198PubMedCrossRef
8.
Zurück zum Zitat Brouwer RW, Bierma-Zeinstra SM, van Raaij TM, Verhaar JA (2006) Osteotomy for medial compartment arthritis of the knee using a closing wedge or an opening wedge controlled by a Puddu plate. A one-year randomised, controlled study. J Bone Joint Surg Br 88(11):1454–1459PubMedCrossRef Brouwer RW, Bierma-Zeinstra SM, van Raaij TM, Verhaar JA (2006) Osteotomy for medial compartment arthritis of the knee using a closing wedge or an opening wedge controlled by a Puddu plate. A one-year randomised, controlled study. J Bone Joint Surg Br 88(11):1454–1459PubMedCrossRef
9.
Zurück zum Zitat Dugdale TW, Noyes FR, Styer D (1992) Preoperative planning for high tibial osteotomy. The effect of lateral tibiofemoral separation and tibiofemoral length. Clin Orthop Relat Res 274:248–264PubMed Dugdale TW, Noyes FR, Styer D (1992) Preoperative planning for high tibial osteotomy. The effect of lateral tibiofemoral separation and tibiofemoral length. Clin Orthop Relat Res 274:248–264PubMed
10.
Zurück zum Zitat Hassenpflug J, von Haugwitz A, Hahne HJ (1998) Long-term results of tibial head osteotomy. Z Orthop Ihre Grenzgeb 136(2):154–161PubMedCrossRef Hassenpflug J, von Haugwitz A, Hahne HJ (1998) Long-term results of tibial head osteotomy. Z Orthop Ihre Grenzgeb 136(2):154–161PubMedCrossRef
11.
Zurück zum Zitat Hernigou P, Medevielle D, Debeyre J, Goutallier D (1987) Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study. J Bone Joint Surg Am 69(3):332–354PubMed Hernigou P, Medevielle D, Debeyre J, Goutallier D (1987) Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study. J Bone Joint Surg Am 69(3):332–354PubMed
12.
Zurück zum Zitat Hoell S, Suttmoeller J, Stoll V, Fuchs S, Gosheger G (2005) The high tibial osteotomy, open versus closed wedge, a comparison of methods in 108 patients. Arch Orthop Trauma Surg 125(9):638–643PubMedCrossRef Hoell S, Suttmoeller J, Stoll V, Fuchs S, Gosheger G (2005) The high tibial osteotomy, open versus closed wedge, a comparison of methods in 108 patients. Arch Orthop Trauma Surg 125(9):638–643PubMedCrossRef
13.
Zurück zum Zitat Insall JN, Ranawat CS, Aglietti P, Shine J (1976) A comparison of four models of total knee-replacement prostheses. J Bone Joint Surg Am 58(6):754–765PubMed Insall JN, Ranawat CS, Aglietti P, Shine J (1976) A comparison of four models of total knee-replacement prostheses. J Bone Joint Surg Am 58(6):754–765PubMed
14.
Zurück zum Zitat King-Martinez AC, Cuellar-Avaroma A, Perez-Correa J, Torres-Gonzalez R, Guevara-Lopez U (2007) High tibial dome osteotomy complications in genu varum patients. Rev Med Inst Mex Seguro Soc 45(2):111–116PubMed King-Martinez AC, Cuellar-Avaroma A, Perez-Correa J, Torres-Gonzalez R, Guevara-Lopez U (2007) High tibial dome osteotomy complications in genu varum patients. Rev Med Inst Mex Seguro Soc 45(2):111–116PubMed
15.
Zurück zum Zitat Kolb W, Guhlmann H, Windisch C, Kolb K, Koller H, Grutzner P (2009) Opening-wedge high tibial osteotomy with a locked low-profile plate. J Bone Joint Surg Am 91(11):2581–2588PubMedCrossRef Kolb W, Guhlmann H, Windisch C, Kolb K, Koller H, Grutzner P (2009) Opening-wedge high tibial osteotomy with a locked low-profile plate. J Bone Joint Surg Am 91(11):2581–2588PubMedCrossRef
16.
Zurück zum Zitat Kolb W, Guhlmann H, Windisch C, Koller H, Grutzner P, Kolb K (2010) Opening-wedge high tibial osteotomy with a locked low-profile plate: surgical technique. J Bone Joint Surg Am 92(Suppl 1 Pt 2):197–207PubMed Kolb W, Guhlmann H, Windisch C, Koller H, Grutzner P, Kolb K (2010) Opening-wedge high tibial osteotomy with a locked low-profile plate: surgical technique. J Bone Joint Surg Am 92(Suppl 1 Pt 2):197–207PubMed
17.
Zurück zum Zitat Lobenhoffer P, Agneskirchner JD (2003) Improvements in surgical technique of valgus high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 11(3):132–138PubMed Lobenhoffer P, Agneskirchner JD (2003) Improvements in surgical technique of valgus high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 11(3):132–138PubMed
18.
Zurück zum Zitat Magyar G, Ahl TL, Vibe P, Toksvig-Larsen S, Lindstrand A (1999) Open-wedge osteotomy by hemicallotasis or the closed-wedge technique for osteoarthritis of the knee. A randomised study of 50 operations. J Bone Joint Surg Br 81(3):444–448PubMedCrossRef Magyar G, Ahl TL, Vibe P, Toksvig-Larsen S, Lindstrand A (1999) Open-wedge osteotomy by hemicallotasis or the closed-wedge technique for osteoarthritis of the knee. A randomised study of 50 operations. J Bone Joint Surg Br 81(3):444–448PubMedCrossRef
19.
Zurück zum Zitat Marti RK, Verhagen RA, Kerkhoffs GM, Moojen TM (2001) Proximal tibial varus osteotomy. Indications, technique, and five to twenty-one-year results. J Bone Joint Surg Am 83-A(2):164–170PubMed Marti RK, Verhagen RA, Kerkhoffs GM, Moojen TM (2001) Proximal tibial varus osteotomy. Indications, technique, and five to twenty-one-year results. J Bone Joint Surg Am 83-A(2):164–170PubMed
20.
Zurück zum Zitat Miller BS, Joseph TA, Barry EM, Rich VJ, Sterett WI (2007) Patient satisfaction after medial opening high tibial osteotomy and microfracture. J Knee Surg 20(2):129–133PubMed Miller BS, Joseph TA, Barry EM, Rich VJ, Sterett WI (2007) Patient satisfaction after medial opening high tibial osteotomy and microfracture. J Knee Surg 20(2):129–133PubMed
21.
Zurück zum Zitat Nelissen EM, van Langelaan EJ, Nelissen RG (2010) Stability of medial opening wedge high tibial osteotomy: a failure analysis. Int Orthop 34(2):217–223PubMedCrossRef Nelissen EM, van Langelaan EJ, Nelissen RG (2010) Stability of medial opening wedge high tibial osteotomy: a failure analysis. Int Orthop 34(2):217–223PubMedCrossRef
22.
Zurück zum Zitat Niemeyer P, Schmal H, Hauschild O, von Heyden J, Sudkamp NP, Kostler W (2010) Open-wedge osteotomy using an internal plate fixator in patients with medial-compartment gonarthritis and varus malalignment: 3-year results with regard to preoperative arthroscopic and radiographic findings. Arthroscopy 26(12):1607–1616PubMedCrossRef Niemeyer P, Schmal H, Hauschild O, von Heyden J, Sudkamp NP, Kostler W (2010) Open-wedge osteotomy using an internal plate fixator in patients with medial-compartment gonarthritis and varus malalignment: 3-year results with regard to preoperative arthroscopic and radiographic findings. Arthroscopy 26(12):1607–1616PubMedCrossRef
23.
Zurück zum Zitat Ranawat CS, Shine JJ (1973) Duo-condylar total knee arthroplasty. Clin Orthop Relat Res 94:185–195PubMedCrossRef Ranawat CS, Shine JJ (1973) Duo-condylar total knee arthroplasty. Clin Orthop Relat Res 94:185–195PubMedCrossRef
24.
Zurück zum Zitat Schröter S, Gonser CE, Konstantinidis L, Helwig P, Albrecht D (2011) High complication rate after biplanar open wedge high tibial osteotomy stabilized with a new spacer plate (position HTO Plate) without bone substitute. Arthroscopy 27(5):644–652PubMedCrossRef Schröter S, Gonser CE, Konstantinidis L, Helwig P, Albrecht D (2011) High complication rate after biplanar open wedge high tibial osteotomy stabilized with a new spacer plate (position HTO Plate) without bone substitute. Arthroscopy 27(5):644–652PubMedCrossRef
25.
Zurück zum Zitat Spahn G (2004) Complications in high tibial (medial opening wedge) osteotomy. Arch Orthop Trauma Surg 124(10):649–653PubMedCrossRef Spahn G (2004) Complications in high tibial (medial opening wedge) osteotomy. Arch Orthop Trauma Surg 124(10):649–653PubMedCrossRef
26.
Zurück zum Zitat Staubli AE, De Simoni C, Babst R, Lobenhoffer P (2003) TomoFix: a new LCP-concept for open wedge osteotomy of the medial proximal tibia–early results in 92 cases. Injury 34(Suppl 2):B55–B62PubMedCrossRef Staubli AE, De Simoni C, Babst R, Lobenhoffer P (2003) TomoFix: a new LCP-concept for open wedge osteotomy of the medial proximal tibia–early results in 92 cases. Injury 34(Suppl 2):B55–B62PubMedCrossRef
27.
Zurück zum Zitat Sterett WI, Steadman JR, Huang MJ, Matheny LM, Briggs KK (2010) Chondral resurfacing and high tibial osteotomy in the varus knee: survivorship analysis. Am J Sports Med 38(7):1420–1424PubMedCrossRef Sterett WI, Steadman JR, Huang MJ, Matheny LM, Briggs KK (2010) Chondral resurfacing and high tibial osteotomy in the varus knee: survivorship analysis. Am J Sports Med 38(7):1420–1424PubMedCrossRef
28.
Zurück zum Zitat Takeuchi R, Aratake M, Bito H, Saito I, Kumagai K, Ishikawa H, Akamatsu Y, Sasaki Y, Saito T (2008) Simultaneous bilateral opening-wedge high tibial osteotomy with early full weight-bearing exercise. Knee Surg Sports Traumatol Arthrosc 16(11):1030–1037PubMedCrossRef Takeuchi R, Aratake M, Bito H, Saito I, Kumagai K, Ishikawa H, Akamatsu Y, Sasaki Y, Saito T (2008) Simultaneous bilateral opening-wedge high tibial osteotomy with early full weight-bearing exercise. Knee Surg Sports Traumatol Arthrosc 16(11):1030–1037PubMedCrossRef
29.
Zurück zum Zitat Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49PubMed Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49PubMed
30.
Zurück zum Zitat Zhang HN, Zhang J, Lv CY, Leng P, Wang YZ, Wang XD, Wang CY (2009) Modified biplanar open-wedge high tibial osteotomy with rigid locking plate to treat varus knee. J Zhejiang Univ Sci B 10(9):689–695PubMedCrossRef Zhang HN, Zhang J, Lv CY, Leng P, Wang YZ, Wang XD, Wang CY (2009) Modified biplanar open-wedge high tibial osteotomy with rigid locking plate to treat varus knee. J Zhejiang Univ Sci B 10(9):689–695PubMedCrossRef
Metadaten
Titel
Return to work and clinical outcome after open wedge HTO
verfasst von
Steffen Schröter
Johannes Mueller
Ronald van Heerwaarden
Philipp Lobenhoffer
Ulrich Stöckle
Dirk Albrecht
Publikationsdatum
01.01.2013
Verlag
Springer-Verlag
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 1/2013
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-012-2129-9

Weitere Artikel der Ausgabe 1/2013

Knee Surgery, Sports Traumatology, Arthroscopy 1/2013 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.