Effect of osteoarthritis severity on survival and clinical outcomes after high tibial osteotomy |
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| Affiliation: | 1. Department of Orthopaedic Surgery, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan;2. Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan;3. Department of Orthopaedic Surgery, Japan Community Health Care Organization, Kyushu Hospital, 1-8-1 Kishinoura, Yahatanishi-ku, Kitakyushu 806-8501, Japan;1. The Centre for Orthopaedics, Beacon Hospital, Beacon Court, Sandyford, Dublin D18 AK67, Ireland;2. University College Dublin School of Medicine, Belfield, Dublin 4, Ireland;3. Aut Even Hospital, Freshford Road, Kilkenny, Co. Kilkenny, Ireland;1. Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan;2. Department of Orthopaedic Biomaterial Science, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan;3. Department of Information Systems, Faculty of Engineering, Saitama Institute of Technology, 1690 Fusaiji, Fukaya, Saitama 369-0293, Japan;1. Second Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan;2. Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital, Tokyo, Japan;3. Graduate School of Medical Technology and Health Welfare Sciences, Hiroshima International University, Hiroshima, Japan;1. Department of Orthopaedic Surgery, Hyogo College of Medicine, Japan;2. Department of Orthopaedic Surgery, Nishinomiya Kaisei Hospital, Japan;3. Diakonie Klinikum Jung-Stilling, Siegen, Germany;1. Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan;2. Department of Orthopaedic Surgery, Tokyo Women''s Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan;3. Department of Orthopaedic Surgery, Japan Community Health Care Organization (JCHO), Kyushu Hospital, 1-8-1 Kishinoura, Yahatanishi-ku, Kitakyushu, 806-8501, Japan;4. Masuda Orthopaedic Hospital, 1-1-1, Korimoto, Kagoshima, 890-0065, Japan |
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| Abstract: | BackgroundThis study aimed to evaluate the effect of osteoarthritis severity on clinical outcomes using the 2011 Knee Society Score (KSS2011) and survival rates after closed wedge high tibial osteotomy (CWHTO).MethodsIn this retrospective study, KSS2011 questionnaires were mailed to patients who had undergone CWHTO between January 1991 and December 2011. The completed questionnaires returned by the patients were analyzed. Preoperative osteoarthritis severity was evaluated by Kellgren-Lawrence (K-L) grade. KSS2011 was compared between the K-L grade groups. To determine the effect of K-L grade for revision surgery, Kaplan-Meier survival curves were created using the need for total knee arthroplasty (TKA) as the endpoint to estimate the probability of failure.ResultsThere were 16, 81, and 47 knees with preoperative K-L 2, 3, and 4, respectively. Among the KSS2011 sub-scores, the symptom score showed significant differences between the groups (p = 0.006). However, no significant difference was found regarding satisfaction, expectation, and functional activity scores. No significant difference in the symptom score was found between the K-L 2 and 3 groups (p > 0.05). Eighteen knees were treated with TKA at a mean of 9 years after CWHTO. Using the Kaplan-Meier survival estimates, the K-L 4 group showed a significantly higher rate of total knee arthroplasty conversion than the K-L 2 and 3 groups (p < 0.001).ConclusionsOsteoarthritis severity affects clinical outcomes and survival rates during long-term follow-up after CWHTO. Surgeons should consider the preoperative osteoarthritis grade for long-term outcomes when considering CWHTO for patients with varus knees. |
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| Keywords: | High tibial osteotomy Osteoarthritis Long-term follow-up Clinical outcome Survival rate |
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