Survival and functional outcome of high tibial osteotomy for medial knee osteoarthritis: a 10–20-year cohort study

Palthe, Alexander F Y van Wulfften; Clement, Nick D; Temmerman, Olivier P.P.; Burger, Bart J.

doi:10.1007/s00590-018-2199-6

Cited by 47 publications

(56 citation statements)

References 21 publications

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“…RTS has been investigated for HTO þ OCA independently, with data on OCA being most comparable with that for our cohort, as studies reporting isolated HTO have older populations and indications of diffuse medial compartment arthritis instead of a focal chondral defect. 3,27,44,45 Nielsen et al 38 reported a 75.2% rate of RTS after isolated OCA of the knee, and McCarthy et al 36 reported a 77% rate of RTS in young, competitive athletes, which are similar to the rate reported in the present study. A meta-analysis and a systematic review have both reported overall rates of RTS after OCA of 88%.…”

Section: Discussionsupporting

confidence: 88%

Return to Sport Following High Tibial Osteotomy With Concomitant Osteochondral Allograft Transplantation

et al. 2020

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Background: Young patients with symptomatic chondral defects in the medial compartment with varus malalignment may undergo opening wedge high tibial osteotomy (HTO) with concomitant osteochondral allograft transplantation (OCA) (HTO + OCA). Although patients have demonstrated favorable outcomes after HTO + OCA, limited information is available regarding return to sporting activities after this procedure. Purpose: To evaluate (1) the timeline to return to sports (RTS), (2) patient satisfaction, and (3) reasons for discontinuing sporting activity after HTO + OCA, and to identify predictive factors of RTS. Study Design: Case series; level of evidence, 4. Methods: Consecutive patients who underwent HTO + OCA for varus deformity and medial femoral condyle focal chondral defects with a minimum 2-year follow-up were retrospectively reviewed. Patients completed a subjective sports questionnaire, satisfaction questionnaire, visual analog scale for pain, and Single Assessment Numerical Evaluation. Results: Twenty-eight patients with a mean age of 36.97 ± 7.52 years were included at mean follow-up of 6.63 ± 4.06 years. Fourteen patients (50.0%) required reoperation during the follow-up period, with 3 (10.7%) undergoing knee arthroplasty. Twenty-four patients participated in sports within 3 years before surgery, with 19 patients (79.2%) able to return to at least 1 sport at a mean 11.41 ± 6.42 months postoperatively. However, only 41.7% (n = 10) were able to return to their preoperative level. The most common reasons for sports discontinuation (n = 20; 83.3%) were a desire to prevent further damage to the knee (70.0%), persistent pain (55.0%), persistent swelling (30.0%), and fear (25.0%). Conclusion: In young, active patients with varus deformity and focal medial femoral condyle chondral defects, HTO + OCA enabled 79.2% of patients to RTS by 11.41 ± 6.42 months postoperatively. However, only 41.7% of patients were able to return to their preinjury level or better. It is imperative that patients be appropriately educated to manage postoperative expectations regarding sports participation after HTO + OCA.

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Section: Discussionsupporting

confidence: 88%

Return to Sport Following High Tibial Osteotomy With Concomitant Osteochondral Allograft Transplantation

et al. 2020

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“…The operation principle of HTO is to transfer the pressure load in unicompartment by adjusting the force line of the lower extremities so as to relieve pain, restore knee joint function, and prolong knee joint life [ 5 ]. Numerous studies have shown that HTO has been proven to be a reliable treatment with good short- and medium-term efficacy for KOA after years of clinical practice [ 6 – 8 ]. In recent years, a growing number of orthopedic surgeons have shown great interest in HTO surgery due to a substantial increase in the number of patients with KOA [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Research trends and hotspots of high tibial osteotomy in two decades (from 2001 to 2020): a bibliometric analysis

et al. 2020

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Background The purpose of this study is to comprehensively analyze the global application trend of high tibial osteotomy (HTO) and identify promising research hotspots of HTO based on bibliometrics and visual analysis. Methods Publications (articles and reviews) related to HTO from 2001 to 2020 were retrieved from the Web of Science Core Collection database (WOSCC). The country, institution, year, author, journal, average citations per item, H index, title, abstract, keywords of publication, and the top 10 cited articles were extracted and analyzed in detail. The VOSviewer software was used to analyze theco-occurrence of keywords to predict the hotspots of HTO. Results A total of 1883 articles were included. In the past 20 years, the number of HTO articles has shown an increasing trend in general. The top 3 countries (the USA, Germany, and South Korea) accounted for 49.547% of all articles published. The USA has the largest number of publications. The University of Western Ontario is the largest contributor. The Knee Surgery Sports Traumatology Arthroscopy is the most influential journal. Professors Saito T and Imhoff AB are the leading scholars who made great achievements in the HTO field. The research direction can be divided into the following 5 clusters: "prognosis and outcome", "HTO combined with cartilage restoration techniques", "animal experimental research", "study on bone union and plate fixation at osteotomy", and "surgical technique research". Conclusion In terms of the trend of previous years, an increasing number of literatures related to HTO will be published in the future. The USA is a world leader in the field of HTO. South Korea presented great potential in this area. HTO combined with cartilage restoration techniques, postoperative prognosis and outcome, and surgical technique research may be the future hotspots in the field of HTO research.

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“…The survival of UKA is secondary to that of total knee arthroplasties (TKA) with a recent meta-analysis reporting 15-year survival of 76% and 93%, respectively (Evans et al 2019). The long-term survival of HTO seems inferior to both UKA and TKA with a declining survival from 75% at 10 years to 55% at 15 years (van Wulfften Palthe et al 2018). When UKA or HTO fail, conversion to TKA is a common solution (Lee et al 2019).…”

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confidence: 99%

Reduced survival of total knee arthroplasty after previous unicompartmental knee arthroplasty compared with previous high tibial osteotomy: a propensity-score weighted mid-term cohort study based on 2,133 observations from the Danish Knee Arthroplasty Registry

et al. 2020

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Survival and functional outcome of high tibial osteotomy for medial knee osteoarthritis: a 10–20-year cohort study

Abstract: The medium- to long-term survival and functional outcome after HTO was good to excellent at 10-20 years of follow-up. Age, gender, surgeon and surgical technique were identified as independent predictors of failure.

Cited by 47 publications

References 21 publications

Return to Sport Following High Tibial Osteotomy With Concomitant Osteochondral Allograft Transplantation

Return to Sport Following High Tibial Osteotomy With Concomitant Osteochondral Allograft Transplantation

Research trends and hotspots of high tibial osteotomy in two decades (from 2001 to 2020): a bibliometric analysis

Reduced survival of total knee arthroplasty after previous unicompartmental knee arthroplasty compared with previous high tibial osteotomy: a propensity-score weighted mid-term cohort study based on 2,133 observations from the Danish Knee Arthroplasty Registry

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