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'Kissing lesions' amenable to marrow stimulation followed by HTO

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GENEVA — German researchers reported good results with an opening-wedge high tibial osteotomy (HTO) combined with abrasion arthroplasty at a mean follow-up of 44 months in patients aged older than 65 years regardless of their body weight, as well as in patients with bicompartmental lesions, according to a presentation at the European Society of Sports Traumatology, Knee Surgery and Arthroscopy Congress 2012, here.

“The high tibial osteotomy in combination with abrasion arthroplasty delivered quite a high amount of pain-free patients,” with 80% of patients having mean postoperative pain scores of 0, Deike Varoga, MD, PhD, of the University Medical Center Schleswig-Holstein, in Kiel, Germany, said. Among those included in the team’s retrospective study, “94% of the patients benefitted from high tibial osteotomy and 85% of the patients would repeat it if they had pain on the other side.”

Varoga and colleagues studied results of 49 patients who underwent microfracture or abrasion arthroplasty 7 days before they had opening-wedge HTO stabilized with a plate. The results in patients aged between 44 and 65 years were compared to those aged 65 years or more, and they indicated there were no significant differences in the outcome scores used or based on patient age, according to the abstract. 

Furthermore, the subjective scores that Varoga and colleagues used were not significantly different postoperatively for the 30 patients with a body mass index (BMI) between 26 and 30. This was also the case, Varoga said, in 11 patients with a BMI greater than 30.

He said there was no influence on the results if patients had a bicompartmental or “kissing” lesion.

The patients had Orthopädische Arbeitsgruppe Knie — OAK — scores and Lysholm scores of 80 points or more, International Knee Documentation Committee scores of 75 points or more and they attained WOMAC scores of 1 to 2 points, according to Varoga.

Reference:

Varoga D, Hartz C, Meyer D, et al. The clinical outcome after high tibial osteotomy does not depend on age, BMI or the extent of cartilage lesion. Paper #FP21-932. Presented at the European Society of Sports Traumatology, Knee Surgery and Arthroscopy Congress 2012. May 2-5. Geneva.