Long-term survival rate of closing wedge high tibial osteotomy with high valgus correction: a 15-year follow-up study

Abstract

Purpose The inluence of closing wedge high tibial osteotomy (CW-HTO) with high valgus correction on its survival is unclear. This study aimed to conduct a 15-year follow-up cohort study to estimate the long-term survival rate of CW-HTO. Factors related to poor outcomes were investigated. Methods A total of 159 knees in 123 patients were followed up, and 120 knees in 96 patients were enrolled for statistical analysis. Femorotibial angles were measured by standing anterior-posterior radiographs of the knee. Clinical objective evaluation was performed by the Japanese orthopaedic association (JOA) score of the knee, and scores lower than 70 points deined the poor result (PR) group. The survival rate of OW-HTO was estimated. Logistic regression analyses were performed to determine the risk factors for PR and conversion to total knee arthroplasty (TKA). Results A total of 16 knees in 15 patients (13.3%) underwent TKA 14.0 ± 4.8 (4-20) years after CW-HTO. The 5-year survival rate was 99.2%, 10-year was 96.7%, 15-year was 92.5%, and 86.7% at inal follow-up (17.9 years). Based on the JOA score, 44 patients (35.8%) belonged to the PR group, and their risk factors were obesity (p = 0.018), low femorotibial angle (p = 0.019), low JOA score (p = 0.040), low knee extension angle (p = 0.045), and low knee lexion angle (p = 0.046). Conclusions The 15-year survival rate of CW-HTO was 92.5%. While higher scores of objective outcomes were kept over long-term follow-up, the risk factors for a worsening score or TKA conversion were obesity and severity of preoperative knee symptoms. KeywordsClosed wedge high tibial osteotomy • Survival rate • 15 years • JOA scores • Total knee arthroplasty conversion * Eiji Sasaki

Human umbilical cord-blood-derived mesenchymal stem cell can improve the clinical outcome and Joint space width after high tibial osteotomy

“…High tibial osteotomy (HTO) is a well-established surgery for patients with medial osteoarthritis (OA) with varus alignment. Many studies have reported long-term survival to be over 80% [1][2][3][4][5][6]. Furthermore, a combined cartilage regeneration procedure such as microfracture (MFx) has an even better survival rate in the long-term [7][8][9].…”

Clinical Outcomes of Revision Total Knee Arthroplasty after High Tibial Osteotomy and Unicompartmental Knee Arthroplasty: A Systematic Review and Meta‐Analysis

“…Studies have shown that HTO yields good clinical outcomes and survival rates; however, the symptoms of osteoarthritis will gradually worsen with the progression of the disease. According to literature reports, the 10‐year survival rate of HTO is approximately 75%–96%, with a 15‐year survival of 55% to 92% 18 , 19 . The number of UKA applications in clinical practice is increasing annually.…”

Using a Patient-Specific 3D-Printed Surgical Guide for High Tibial Osteotomy: A Technical Note

“…Both OWHTO and lateral closing-wedge high tibial osteotomy (CWHTO) can obtain relatively ideal midand long-term curative effects [25] . OWHTO has recently become a mainstream technique, as it has been reported to have advantages over CWHTO [26][27] , such as fewer chances of neurovascular injuries, and better survival, preservation of bone mass, and simplicity.…”