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Knee Surgery, Sports Traumatology, Arthroscopy

Erschienen in:

07.07.2016 | Knee

Progression of medial compartmental osteoarthritis 2–8 years after lateral closing-wedge high tibial osteotomy

verfasst von: M. R. Huizinga, J. Gorter, A. Demmer, S. M. A. Bierma-Zeinstra, R. W. Brouwer

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 12/2017

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Abstract

Purpose

The primary purpose of this study is to investigate the progression of medial osteoarthritis (OA) following lateral closing-wedge high tibial osteotomy (HTO). Secondary outcomes included functional and pain scores.

Methods

This prospective cohort study analysed 298 patients treated with lateral closing-wedge HTO surgery for medial compartmental OA. OA progression was measured by comparing the minimum joint space width (mJSW) and Kellgren–Lawrence (KL) score on radiographs preoperatively and postoperatively. The WOMAC score and NRS score for pain were obtained preoperatively and postoperatively to assess secondary outcomes. Failure was defined as revision surgery; survival was estimated.

Results

Mean follow-up was 5.2 ± 1.8 years (range 2–8.5). Mean preoperative mJSW was 3.4 ± 1.6 mm, which changed nonsignificantly (p = 0.51) to 3.4 ± 1.7 mm postoperatively. Mean annual joint space narrowing was 0.02 ± 0.34 mm/year. Progression to 1 KL grade or more was seen in 132 (44 %) patients, and annual risk of KL progression was 8.6 %. No KL progression was seen in 56 % of patients. Mean NRS decreased from 7.3 ± 1.5 to 3.5 ± 2.5 (p < 0.001). WOMAC scores decreased from 48.0 ± 17.2 to 23.6 ± 19.7 (p < 0.001). Failure was seen in 21 patients.

Conclusion

Compared to demographic data in the literature, valgus high tibial osteotomy seems to reduce the progression of OA, reduces pain and improves knee function in patients with medial compartment OA and a varus alignment.

Level of evidence

III.

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Titel: Progression of medial compartmental osteoarthritis 2–8 years after lateral closing-wedge high tibial osteotomy
verfasst von: M. R. Huizinga
J. Gorter
A. Demmer
S. M. A. Bierma-Zeinstra
R. W. Brouwer
Publikationsdatum: 07.07.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 12/2017
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-016-4232-9

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