Mid-term results of medial open-wedge high tibial osteotomy based on radiological grading of osteoarthritis
- 02.07.2021
- Orthopaedic Surgery
Erschienen in:
- Verfasst von
- Yasuhiro Takahara
- Hirotaka Nakashima
- Satoru Itani
- Haruyoshi Katayama
- Kazuaki Miyazato
- Yuichi Iwasaki
- Hisayoshi Kato
- Yoichiro Uchida
- Erschienen in
- Archives of Orthopaedic and Trauma Surgery | Ausgabe 1/2023
Abstract
Purpose
To evaluate the mid-term results of medial open-wedge high tibial osteotomy (OWHTO) based on Kellgren–Lawrence (KL) grades.
Materials and methods
We retrospectively evaluated clinical and radiographic outcomes of 93 patients (mean age 61.4 years, mean follow-up 64.2 months, 109 consecutive knees) who underwent OWHTO for medial compartment osteoarthritis (OA). KL grade was used to evaluate knee OA (KL-1 22 cases; KL-2, 51 cases; KL-3, 36 cases). The clinical outcomes were assessed using Japanese Orthopaedic Association (JOA) and Lysholm scores. Radiographic outcomes were assessed using pre- and post-operative mechanical axis percentage, femorotibial angle, medial proximal tibial angle, and joint line convergence angle. Hinge fracture frequency and OA progression were also evaluated based on KL grades.
Results
The JOA score improved significantly from 70.3 ± 14.9 to 96.2 ± 4.4, 64.1 ± 12.5 to 95.1 ± 5.1, and 68.6 ± 11.4 to 92.1 ± 6.1 in the KL-1, KL-2, and KL-3 groups, respectively. The JOA score in the KL-3 group was significantly lower than in the other groups. The Lysholm score improved significantly from 62.6 ± 8.8 to 97.7 ± 4.7, 62.1 ± 8.1 to 96.7 ± 4.2, and 59.2 ± 9.2 to 95.8 ± 4.6 in the KL-1, KL-2, and KL-3 groups, respectively. The post-operative Lysholm scores were not significantly different among the groups.
There were significant differences in radiographic parameters pre-operatively, but not post-operatively, among the groups. Although there were no significant differences in hinge fracture frequency and OA progression, the KL-3 grade predicted OA progression on multivariate analysis.
Conclusions
Mid-term results of OWHTO significantly improved. However, clinical score in the KL-3 group was lower than that in the KL-1 and KL-2 groups; radiological OA progression was a risk factor in KL-3.
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- Titel
- Mid-term results of medial open-wedge high tibial osteotomy based on radiological grading of osteoarthritis
- Verfasst von
-
Yasuhiro Takahara
Hirotaka Nakashima
Satoru Itani
Haruyoshi Katayama
Kazuaki Miyazato
Yuichi Iwasaki
Hisayoshi Kato
Yoichiro Uchida
- Publikationsdatum
- 02.07.2021
- Verlag
- Springer Berlin Heidelberg
- Erschienen in
-
Archives of Orthopaedic and Trauma Surgery / Ausgabe 1/2023
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916 - DOI
- https://doi.org/10.1007/s00402-021-04011-x
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