Abstract
Knee osteoarthrosis (OA) is a widespread orthopedic problem and a high tibial osteotomy (HTO) is a common treatment to minimize degeneration of the affected compartment. The primary aim of this study was to evaluate the postural regulation and stability among patients who underwent HTO and rehabilitation. This prospective study included 32 patients (55.3 ± 5.57 years) diagnosed with medial tibiofemoral OA. Each subject completed postural regulation and stability testing (Interactive Balance System), as well as pain intensity (visual analogue scale) and quality of life questionnaires (SF-36) prior to HTO (exam 1), and at six weeks (exam 2), twelve weeks (exam 3) and six months (exam 4) post HTO. For postural comparison, all patients were matched (sex, age, height) with asymptomatic subjects. Significant time effects (exam 1 vs. exam 4) were found for weight distribution index (WDI; ηp2 = 0.152), mediolateral weight distribution ηp2 = 0.163) and anterior–posterior weight distribution ηp2 = 0.131). The largest difference (exam 3: ηp2 = 0.251) and the most significant differences to the matched sample were calculated for the stability indicator (exam 1: ηp2 = 0.237; exam 2: ηp2 = 0.215; exam 3: ηp2 = 0.251; exam 4: ηp2 = 0.229). Pain intensity showed a significant reduction (ηp2 = 0.438) from exam 1 (50.7 ± 20.0 mm) to exam 4 (19.3 ± 16.0 mm). Physical pain was the quality of life parameter with the largest improvement between exams 1 and 4 (ηp2 = 0.560). HTO allows patients to improve their mediolateral weight distribution, whereas postural stability is consistently lower than in asymptomatic subjects. This surgery leads to marked improvements in quality of life and pain.
Highlights
For more than 25% of patients under the age of 70 years, knee osteoarthritis (OA) is a widespread orthopedic problem [1]
Significant mean differences were detected for weight (p = 0.001, ηp 2 = 0.152) and body mass index (BMI) (p = 0.007, ηp 2 = 0.110)
The findings of this investigation indicate that High tibial osteotomy (HTO) patients do not present with improvements in postural performance following surgery and rehabilitation
Summary
For more than 25% of patients under the age of 70 years, knee osteoarthritis (OA) is a widespread orthopedic problem [1]. High tibial osteotomy (HTO) is a well-established and often recommended surgical option for medial compartment knee OA in patients with varus malalignment [3,4]. This surgical intervention is indicated for varus deformities of 5◦ or greater in patients with cartilage defects and who are able to defer total knee arthroplasty (TKA) [5,6]. Previous research has investigated the effectiveness of using an opening-wedge HTO to evaluate cartilage quality [8,9,10,11] and compared HTO and knee joint distraction as an alternative surgical treatment for OA [6,12]. Bastard et al [13] investigated the influence of HTO on return to sport at one year postoperative using the Tegner score (primary outcome) and quality of life questionnaire (SF-36)
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