Change in gait after high tibial osteotomy: A systematic review and meta-analysis |
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| Affiliation: | 2. Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea;3. Department of Neurology, Stroke Center, Seoul National University Bundang Hospital, College of Medicine, Seoul National University, Seongnam, Republic of Korea;4. Department of Radiology, Stroke Center, Seoul National University Bundang Hospital, College of Medicine, Seoul National University, Seongnam, Republic of Korea;6. Department of Neurology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea;2. Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea;3. Department of Neurology, Eulji University Hospital, Daejeon, Republic of Korea;4. Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Republic of Korea;6. Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea;5. Department of Neurology, Ilsan Paik Hospital, Inje University, Goyang, Republic of Korea;11. Department of Neurology, Dongguk University Ilsan Hospital, Goyang, Republic of Korea;12. Department of Neurology, Dong-A University College of Medicine, Busan, Republic of Korea;8. Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea;10. Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea;9. Clinical Research Center, Asan Medical Center, Seoul, Republic of Korea |
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| Abstract: | We conducted a meta-analysis to analyze how high tibial osteotomy (HTO) changes gait and focused on the following questions: (1) How does HTO change basic gait variables? (2) How does HTO change the gait variables in the knee joint? Twelve articles were included in the final analysis. A total of 383 knees was evaluated. There were 237 open wedge (OW) and 143 closed wedge (CW) HTOs. There were 4 level II studies and 8 level III studies. All studies included gait analysis and compared pre- and postoperative values. One study compared CWHTO and unicompartmental knee arthroplasty (UKA), and another study compared CWHTO and OWHTO. Five studies compared gait variables with those of healthy controls. One study compared operated limb gait variables with those in the non-operated limb. Gait speed, stride length, knee adduction moment, and lateral thrust were major variables assessed in 2 or more studies. Walking speed increased and stride length was increased or similar after HTO compared to the preoperative value in basic gait variables. Knee adduction moment and lateral thrust were decreased after HTO compared to the preoperative knee joint gait variables. Change in co-contraction of the medial side muscle after surgery differed depending on the degree of frontal plane alignment. The relationship between change in knee adduction moment and change in mechanical axis angle was controversial. Based on our systematic review and meta-analysis, walking speed and stride length increased after HTO. Knee adduction moment and lateral thrust decreased after HTO compared to the preoperative values of gait variables in the knee joint. |
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| Keywords: | Knee Osteoarthritis High tibial osteotomy Gait analysis Knee adduction moment |
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