Medial open wedge high tibial osteotomy is a viable option in young patients with advanced arthritis in a long-term follow-up

IF 5 2区医学 Q1 ORTHOPEDICS Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2024-09-18 DOI:10.1002/ksa.12469

Nifon K. Gkekas, George A. Komnos, Theodoros Mylonas, Georgios Chalatsis, Antonios A. Koutalos, Michael E. Hantes

{"title":"Medial open wedge high tibial osteotomy is a viable option in young patients with advanced arthritis in a long-term follow-up","authors":"Nifon K. Gkekas, George A. Komnos, Theodoros Mylonas, Georgios Chalatsis, Antonios A. Koutalos, Michael E. Hantes","doi":"10.1002/ksa.12469","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>This study aimed to evaluate the long-term outcomes of medial open wedge high tibial osteotomy (MOWHTO) as a treatment option for advanced medial compartment knee osteoarthritis (OA) Kellgren–Lawrence (K-L) III and IV.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Patients with severe medial compartment arthritis, who underwent MOWHTO with locking plate between 2003 and 2015, were retrospectively reviewed. A locking plate for the osteotomy was utilized. Preoperative and postoperative patients’ evaluation was performed using the International Knee Documentation Committee Score (IKDC), the Oxford Knee Score (OKS), the Knee Injury Osteoarthritis Outcome Score (KOOS) and the Short Form-12 Score (SF-12). Standardized standing whole-limb X-rays were taken to evaluate the mechanical tibiofemoral angle (mTFA) and proximal medial tibial angle (PMTA), and the severity of OA.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 32 patients, 35 knees (27 males, five females) of which 21 were classified as K-L Grade III and 14 as K-L Grade IV, and mean age 47.1 ± 9.17 years old, who were followed for 13.6 years (range 7–20 years), were included in the study. During the follow-up period, three knees required conversion to total knee replacement (91.5% survival rate). All clinical outcome scores (KOOS, OKS, IKDC and SF-12) showed a significant improvement compared to preoperative status (<i>p</i> < 0.05). Preoperative mTFA and PMTA were significantly corrected immediately after surgery and retained this improvement at the last follow-up.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>MOWHTO with a locking plate is an effective method to treat severe medial compartments. Clinical and radiological results are satisfactory and the survival rate is 91.5%, at a mean follow-up of 13.6 years after the procedure.</p>\n </section>\n \n <section>\n \n <h3> Level of Evidence</h3>\n \n <p>Level IV.</p>\n </section>\n </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 3","pages":"1025-1032"},"PeriodicalIF":5.0000,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12469","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee Surgery, Sports Traumatology, Arthroscopy","FirstCategoryId":"3","ListUrlMain":"https://esskajournals.onlinelibrary.wiley.com/doi/10.1002/ksa.12469","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

This study aimed to evaluate the long-term outcomes of medial open wedge high tibial osteotomy (MOWHTO) as a treatment option for advanced medial compartment knee osteoarthritis (OA) Kellgren–Lawrence (K-L) III and IV.

Methods

Patients with severe medial compartment arthritis, who underwent MOWHTO with locking plate between 2003 and 2015, were retrospectively reviewed. A locking plate for the osteotomy was utilized. Preoperative and postoperative patients’ evaluation was performed using the International Knee Documentation Committee Score (IKDC), the Oxford Knee Score (OKS), the Knee Injury Osteoarthritis Outcome Score (KOOS) and the Short Form-12 Score (SF-12). Standardized standing whole-limb X-rays were taken to evaluate the mechanical tibiofemoral angle (mTFA) and proximal medial tibial angle (PMTA), and the severity of OA.

Results

A total of 32 patients, 35 knees (27 males, five females) of which 21 were classified as K-L Grade III and 14 as K-L Grade IV, and mean age 47.1 ± 9.17 years old, who were followed for 13.6 years (range 7–20 years), were included in the study. During the follow-up period, three knees required conversion to total knee replacement (91.5% survival rate). All clinical outcome scores (KOOS, OKS, IKDC and SF-12) showed a significant improvement compared to preoperative status (p < 0.05). Preoperative mTFA and PMTA were significantly corrected immediately after surgery and retained this improvement at the last follow-up.

Conclusion

MOWHTO with a locking plate is an effective method to treat severe medial compartments. Clinical and radiological results are satisfactory and the survival rate is 91.5%, at a mean follow-up of 13.6 years after the procedure.

Level of Evidence

Level IV.

Abstract Image

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

在长期随访中，内侧开放式楔形高胫骨截骨术是晚期关节炎年轻患者的可行选择。

目的本研究旨在评估内侧开放式楔形高胫骨截骨术（MOWHTO）作为晚期内侧室膝关节骨性关节炎（OA）Kellgren-Lawrence（K-L）III和IV期治疗方案的长期疗效。方法回顾性研究了2003年至2015年间接受带锁定钢板MOWHTO的严重内侧室关节炎患者。截骨时使用锁定钢板。采用国际膝关节文献委员会评分（IKDC）、牛津膝关节评分（OKS）、膝关节损伤骨关节炎结果评分（KOOS）和简表-12评分（SF-12）对患者进行术前和术后评估。研究共纳入 32 名患者，35 个膝关节（27 名男性，5 名女性），其中 21 个为 K-L III 级，14 个为 K-L IV 级，平均年龄（47.1 ± 9.17）岁，随访 13.6 年（7-20 年）。在随访期间，有三个膝关节需要转为全膝关节置换（存活率为 91.5%）。与术前相比，所有临床结果评分（KOOS、OKS、IKDC 和 SF-12）均有显著改善（P < 0.05）。术前的 mTFA 和 PMTA 在术后立即得到明显改善，并在最后一次随访中保持了这种改善。临床和放射学结果令人满意，术后平均随访 13.6 年，存活率为 91.5%。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).