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‘Kissing’ lesions amenable to marrow stimulation, then high tibial osteotomy
Functional outcomes, scores were not affected by body mass index or when patients aged older or less than 65 years were compared.
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German researchers reported that they found good results with opening-wedge high tibial osteotomy combined with abrasion arthroplasty at a median follow-up of 44 months in patients aged older than 65 years and that many patients were pain-free.
“Based on our study, we conclude that high tibial osteotomy in combination with abrasion arthroplasty provide also good results in bicompartmental gonarthritis and in patients older than 65 years, independent of their body weight,” Deike Varoga, MD, PhD, of the University Medical Center Schleswig-Holstein, in Kiel, Germany, told Orthopaedics Today Europe.
The combination procedure resulted in a high amount of pain-free patients among the 50 patients, 51 knees that were studied. Thirty-nine patients reported mean postoperative Visual Analog Scale scores of 0. Among the patients involved in the retrospective study, “85% of the patients would repeat the surgery if necessary,” Varoga said.
Good scores independent of OA
Varoga and colleagues studied results of 51 knees that underwent microfracture or abrasion arthroplasty seven days before they were treated with an opening-wedge high tibial osteotomy that was stabilized with a plate, according to the abstract of a presentation Varoga gave. The investigators divided the patients into three groups based on the degree of osteoarthritis (OA) they had in their patellofemoral joint.
Image: Varoga D
The researchers then assessed each patient’s Orthopädische Arbeitsgruppe Knie (OAK), Lysholm, International Knee Documentation Committee (IKDC) and WOMAC score, postoperatively.
“Lysholm, WOMAC, OAK and IKDC scores displayed good results independent of the OA in the [patellofemoral joint],” Varoga told Orthopaedics Today Europe.
Age, weight did not affect results
Varoga and colleagues then compared the results in patients aged between 44 years and 65 years to those for the patients aged 65 years or more. According to the abstract of the study, the investigators noted no significant differences in the outcome scores and no differences in the results based on patient age.
Furthermore, the subjective scores that Varoga and colleagues used to evaluate outcomes 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, for the 11 patients with BMI greater than 30.
The results of the study were not affected when patients had medial, as well as additional OA of the patellofemoral joint, Varoga added. – by Jeff Craven
Reference:
Varoga D. Paper #FP21-932. Presented at: European Society of Sports Traumatology, Knee Surgery and Arthroscopy Congress; May 2-5, 2012; Geneva.
For more information:
Deike Varoga, MD, PhD, can be reached at Department of Orthopaedic and Trauma Surgery, Campus Kiel, Michaelis Str. 1, 24105 Kiel, Germany; email:
deike.varoga@uksh-kiel.de.
Disclosure: Varoga has no relevant financial disclosures.