Proximal tibial osteotomy with absorbable spacer combined with fibular osteotomy has similar clinical outcomes to high tibial osteotomy in the treatment of knee osteoarthritis

Yu, Jiahao; Wu, Penghuan; Guo, Haichuan; Chen, Pengzhao; Yuwen, Peizhi; Wang, Juan; Zhang, Yingze

doi:10.1007/s00264-023-05894-8

Cited by 1 publication

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“…Our team first proposed in 2014 that the uneven subsidence of the tibial plateaus based on osteoporosis is the determining factor for knee varus, and subsequently in 2016 and 2018, advocate the use of resorbable spacers or double triangles locking compression plates to fix the osteotomy gap, and with reasonably good clinical outcomes. 10 Theoretically, these two implants are smaller, the surgical incision is more minimal at 4 cm, and they can fix the osteotomy gap securely, overcoming the disadvantages of large plates, 11 but no study has yet confirmed this.…”

Section: Introductionmentioning

confidence: 99%

Increased symptoms of stiffness after opening-wedge high tibial osteotomy are associated with worse postoperative knee function outcomes and lower patient satisfaction rate

Yu,

Song,

Zhu

et al. 2024

J Orthop Surg (Hong Kong)

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Background Symptoms of knee stiffness after open wedge high tibial osteotomy (OW-HTO) can significantly affect surgical effectiveness, but no studies have reported risk factors for knee stiffness after OW-HTO. Methods Patients treated with OW-HTO for the first time between 2018 and 2021 were included. Data were collected on patient demographics, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Short Form (SF) 12 scores, hip-knee-ankle angle (HKA) and patient satisfaction before and after surgery. Patients with worse WOMAC stiffness scores at 1 year were defined as the 'increased stiffness' group and the other cohort as the 'non-stiffness' group. The primary outcome of the study was to compare postoperative knee function scores (WOMAC and SF-12), HKA and patient satisfaction rate between the two groups. The secondary outcome was the use of logistic regression to analyze independent predictors of increased postoperative stiffness symptoms. Results At 1 year postoperatively, 95 (11.3%) patients had a significant increase in stiffness. Patients had significantly ( p < .001) less improvement in pain, function, and total WOMAC scores, and SF-12 score than those in the non-stiffness group ( n = 745). However, the differences in WOMAC and SF-12 scores in increased stiffness group at 1 year post-operatively were statistically significant ( p < .001) compared to the non-stiffness group. There was no statistically significant difference in HKA in the increased stiffness group (172.9° ± 2.3°) compared to non-stiffness group (173.4° ± 2.6°) at 1 year postoperatively ( p = .068). Patient satisfaction was significantly lower in the increased stiffness group ( p < .001). Logistic regression analysis showed that diabetes (odds ratio (OR) 1.809, p = .034) and preoperative WOMAC stiffness score of 44 or less (OR 4.255 p < .001) were predictors of increased stiffness. Conclusions Patients with increased stiffness after OW-HTO had worse functional outcomes and lower patient satisfaction rates and patients at risk of being in this group should be informed pre-operatively.

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Section: Introductionmentioning

confidence: 99%