Patient factors predictive of failure following high tibial osteotomy

Gilat, Ron; Patel, Sumit; Knapik, Derrick M.; Evuarherhe, Aghogho; Haunschild, Eric D.; Parvaresh, Kevin C.; Chahla, Jorge; Yanke, Adam B.; Cole, Brian J.

doi:10.1016/j.jcjp.2021.100012

Cited by 5 publications

(2 citation statements)

References 33 publications

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“…Complications after surgery were observed in 8.8% of patients. Body weight and age were identiőed [5,6] as the two most important factors in HTO failures. However, the performance of concomitant procedures decreased the failure rate.…”

Section: Introductionmentioning

confidence: 99%

Automated correction angle calculation in High Tibial Osteotomy planning

Przystalski

Paleczek

Szustakowski

et al. 2023

Preprint

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High tibial osteotomy correction angle calculation is a process that is usually performed manually or in a semi-automated way. The process, according to the Miniaci method, is divided into several stages to find specific points: the center of the femoral head, the edges of the tibial plateau, the Fujisawa point, the center of the ankle joint, and the Hinge point. In this paper, we proposed an end-to-end approach that consists of different techniques for finding each point. We used YOLOv4 to detect regions of interest. To identify the center of the femoral head, we used the YOLOv4 and the Hough transform. For the other points, we used a combined method of YOLOv4 with the ASM/AAM algorithm and YOLOv4 with image processing algorithms. Our fully-automated method achieved a mean error rate of 0.5◦ (0-2.76◦) ICC 0.99 (0.98-0.99) 95%CI on our own dataset of standing long-leg Anterior Posterior view X-rays. This might be the first method that automatically calculates the correction angle of high tibial osteotomy.

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Section: Introductionmentioning

confidence: 99%

Automated correction angle calculation in High Tibial Osteotomy planning

Przystalski

Paleczek

Szustakowski

et al. 2023

Preprint

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“…9 In terms of patient-reported outcomes after OWHTO, several preoperative factors, intraoperative procedures, and postoperative radiological parameters have been posited as candidate influencing factors. 1,7,27,29 The effects of these various factors suspected of influencing patientreported outcomes have been evaluated using multiple regression analysis in heterogeneous cohorts that included sedentary recipients of OWHTO but not specifically active patient cohorts after they returned to sports. To obtain more satisfying results in active patients, more studies are needed for the clarification of risk factors that can support intraoperative decision making.…”

mentioning

confidence: 99%

Risk Factors Affecting Return to Sports and Patient-Reported Outcomes After Opening-Wedge High Tibial Osteotomy in Active Patients

Katagiri

Shioda

Nakagawa

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Although opening-wedge high tibial osteotomy (OWHTO) is favored for active patients who expect to return to sports, there is still a lack of robust evidence for factors affecting their recovery. Purpose: To identify (1) risk factors leading to a decreased level of return to preoperative sports after OWHTO and (2) patient characteristics and intraoperative factors influencing patient-reported outcomes after return to sports. Study Design: Case-control study; Level of evidence, 3. Methods: Included were 69 patients who underwent OWHTO and who expected to return to their preoperative level of sports, measured as a Tegner activity level ≥2. All included patients had a minimum of 1 year of follow-up data. Logistic regression analyses were performed to assess the effect of independent variables on the level of return to preoperative sports after surgery; the independent variables were age, sex, body mass index, preoperative Tegner score, preoperative Kellgren-Lawrence grade, preoperative percentage of mechanical axis (%MA), opening gap width, concomitant meniscal treatment, postoperative %MA, postoperative medial proximal tibial angle (MPTA), and postoperative posterior tibial slope. Univariate and multiple regression analyses were performed to assess for influencing factors on postoperative International Knee Documentation Committee (IKDC) subjective scores in patients who were able to return to sports. Results: Of the 69 patients, 51 (73.9%) returned to sports after OWHTO. High preoperative Tegner scores were statistically associated with a decrease in return to sports (odds ratio, 1.494; P = .033). Multiple regression analysis (n = 46 patients) identified that a higher postoperative MPTA was associated with a decreased IKDC subjective score after return to sports ( r = –0.345; P = .019). Conclusion: Higher postoperative MPTA was associated with the worsening of patient-reported outcomes among those patients who did return to their preoperative sports after OWHTO. Also, participation in high-activity sports was confirmed to be a significant risk factor for a decreased rate of return to preoperative sports. These findings can support preoperative planning and intraoperative decision making, particularly for active patients.

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Higher conversion rate to knee arthroplasty in female patients following medial open‐wedge high tibial osteotomy

Ahrend,

Petzold,

Schuster

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeMost studies about medial open‐wedge high tibial osteotomy (HTO) reported outcomes without focusing on gender differences. Therefore, the study compared the long‐term survival rate and postoperative subjective knee function after HTO in female versus male patients with symptomatic medial compartment knee osteoarthritis.MethodsThe data of three cohorts with long‐term outcomes were analysed (n = 245; 32% females; age: 49 ± 7 years; Kellgren Lawrence Grade I 6.1%, II 32.7%, III 42.4%; IV 18.8%). The minimum follow‐up was at least 6 years or an earlier conversion to total knee arthroplasty (TKA). The gender‐specific survival rate after HTO was calculated after 5 and 10 years and compared using Kaplan–Meier analysis and the logrank test. Baseline characteristics and subjective knee function (International Knee Documentation Committee [IKDC]/Lysholm) were analysed between both genders.ResultsForty of 78 (51.3%) women and 41 of 167 men (24.5%) underwent TKA. HTO survival in females was significantly lower (p = 0.0010). The 5‐ and 10‐year survival rates were 85.9% and 62.6% for females and 93.4% and 77.7% for males. In females and males, from preoperative to the last follow‐up, the IKDC (43 ± 15 to 58 ± 17; 47 ± 14 to 67 ± 18) and the Lysholm (42 ± 18 to 72 ± 18; 55 ± 22 to 77 ± 23) improved significantly (all p < 0.0001). Females had significantly lower preoperative and postoperative IKDC (p = 0.0438; p = 0.0035) and Lysholm scores (p = 0.0002; p = 0.0323). But the absolute improvements of the IKDC and Lysholm were not significantly different between genders.ConclusionsFemales had higher conversion rates to TKA and lower knee function at the last follow‐up. However, preoperative knee function was lower in females and the absolute improvement following HTO was similar for both genders. In general, females benefit from HTO to treat medial knee arthritis, and TKA could be postponed for half of female patients for more than 10 years. However, surgeons must be aware of the described inferior outcomes in females for realistic patient expectation management.Level of EvidenceLevel II.

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Patient factors predictive of failure following high tibial osteotomy

Cited by 5 publications

References 33 publications

Automated correction angle calculation in High Tibial Osteotomy planning

Automated correction angle calculation in High Tibial Osteotomy planning

Risk Factors Affecting Return to Sports and Patient-Reported Outcomes After Opening-Wedge High Tibial Osteotomy in Active Patients

Higher conversion rate to knee arthroplasty in female patients following medial open‐wedge high tibial osteotomy

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