Study identifies predictors of outcome after varus high tibial osteotomy

Issue: August 2012

Positive predictors of the Oxford Knee Score up to 5 years after varus high tibial osteotomy for patients with knee osteoarthritis include male gender, surgeon experience, no use of pain medication at follow-up and no postoperative complications, according to a recently published study.

Between 2004 and 2006, investigators analyzed 533 patients with medial knee osteoarthritis who underwent open-wedge high tibial osteotomy (HTO) using the Tomofix (Synthes, Bettlach, Switzerland) plate. Researchers collected baseline data and performed a prospective outcome assessment. The Oxford 12-item Knee Score was used to assess functional outcome through telephone interview.

According to Outerbridge classification, 52% of patients had grade III lesions and 33% had grade IV lesions before surgery. The mean Oxford Knee Score was 43 points among the 386 eligible patients who were interviewed for follow-up. Patients with a higher preoperative degree of medial cartilage lesion had lower score results. One local postoperative complication was experienced in 6% of patients. Study results showed a four times greater risk of developing one severe complication — leading to reoperation — among patients who received osteotomy gap filling vs. patients who did not receive a gap filler.

“This study reveals favorable medium-term results after HTO in varus osteoarthritis,” the researchers wrote in their study. “The occurrence of implant-related complications is small using an improved surgical technique and a specific plate fixator. The patient-reported functional outcome is good and comparable to that in [unicompartmental knee arthroplasty] UKA, even in older patients with higher level of medial cartilage damage.”

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Source:

Floerkemeier S. Knee Surg Sports Traumatol Arthrosc. 2012;doi:10.1007/s00167-012-2087-2.