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Finnish registry indicates increasing osteotomy use in younger patients for knee OA

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According to Finnish researchers, although the overall incidence of osteotomies has declined during the past 2 decades, the incidence among women has declined and surgeons are performing more osteotomies in patients younger than 50 years old than in the general population.

“Between in 1987 and 2008 in Finland, the incidence of osteotomies has decreased annually by 6.2% on average,” Tuukka T. Niinimäki, MD, from the Oulu University Hospital in Oulu, Finland, said. “Decline of incidence has been steeper among female patients and in patients less than 50 years of age, the incidence of osteotomies has increased by 1.4% annually.”

Niinimäki and colleagues reviewed the Finnish National Hospital Discharge Register for patients who underwent tibial and femoral osteotomies and the Finnish Arthroplasty Register for patients with unicondylar and total knee arthroplasties. For every osteotomy performed during the study period, patients underwent 3.7 unicondylar knee arthroplasty and 77.1 total knee arthroplasty procedures, Niinimäki said.

 

Tuukka T. Niinimäki

Researchers found 6,004 osteotomies were performed for 5,734 patients. Among these procedures, 36.8% were classified as tibial osteotomies and 2% were femoral osteotomies. Until 1997, both tibial and femoral osteotomies shared the same hospital code in the register, so 61.2% of the osteotomies in the study were classified as either tibial or femoral. However, Niinimäki said more than 90% of these procedures were tibial osteotomies.

In the national register, primary osteoarthritis (OA) was the most common reason for surgical intervention at 90.2%. Secondary OA comprised 5.7% of indications, while post-traumatic OA and non-defined OA were indicated in 3.5% and 0.6% of cases, respectively.

Niinimäki said their study needs further research to understand why the decrease in osteotomies is so steep in women, hypothesizing that poorer osteotomy outcomes could contribute to the decline in procedures.

Reference:

Niinimäki TT. Paper #12-4880. Presented at: 13th EFORT Congress. May 23-25, 2012; Berlin.

Disclosure: Niinimäki has no relevant financial disclosures.