Results Of High Tibial Osteotomy Research Articles

Does preoperative bone marrow edema affect clinical outcomes after medial open-wedge high tibial osteotomy?

PurposeThe aim of this study is to evaluate the results of high tibial osteotomy (HTO) in patients with bone marrow edema (BME) and assess the effect of factors on the subsequent results.MethodsA total of 138 patients who underwent medial open-wedge HTO using locking plate were included in this study. BME was observed in 108 patients using preoperative magnetic resonance imaging. Clinical results were evaluated before HTO and postoperatively at 12 months. Moreover, we evaluated the factors affecting the clinical results.ResultsThe clinical scores were all significantly improved regardless of the presence of BME. There were no differences in improvement of clinical scores between patients with BME and without BME. Patients with BME showed higher postoperative Western Ontario and McMaster Universities Arthritis Index (WOMAC) stiffness scores than patients without BME. Furthermore, patients with BME on both the femur and tibia showed lower Knee Society function scores than patients with BME on either the femur or the tibia. Patients with large BME lesions exhibited a lower Hospital for Special Surgery score and WOMAC pain scores, postoperatively. In patients with BME, patients with undercorrection showed significantly lower improvement in WOMAC pain scores compared with patients with acceptable correction.ConclusionsThe clinical improvement after HTO in patients with varus and medial osteoarthritis was not different regardless of the presence or absence of BME. However, accurate alignment should be considered essential for achieving better clinical outcomes in patients with preoperative BME.

Medium to long term of self-report outcomes of high tibial osteotomy in advanced age patients.

This study aimed to investigate the mid- to long-term benefits of high tibial osteotomy in advanced age patients. This retrospective study was conducted in our hospital from January 2017 to January 2021 with data prospectively collected, 47 patients with knee osteoarthritis who over 65years old were included, and a 1:1 propensity score (PS) of patients < 65years were matched according to gender, body mass index, and side. Patient demographics, intraooperative and postoperative variables, and patient self-reported outcomes were compared. A generalized linear model was used to screen possible risk factors. A total of 94 consecutive patients were included; the average age of advanced age group was 69.47 + 4.26years and 57.87 + 5.51years in the younger group. There were no statistically difference in K-L grade, smoke, drink, comorbidity, ASA, blood loss, operative duration, length of stay, surgical site infection, hinge fracture, DVT, and preooperative and postoperative aFTA; significantly statistical difference of the eFI was found between two groups (P < 0.05). Two groups had comparable VAS and MOMAC scores at one year postoperatively (P > 0.05), while the younger group had lower VAS and WOMAC scores than the advanced age group at the end of follow-up (P < 0.05). Generalized linear model showed both age and eFI were associated with WOMAC scores; there was a statistically significant difference in the effect of eFI on WOMAC scores at different ages (P > 0.05). Compared with younger patients, advanced age patients have similar short-term benefits, but less long-term benefits. We recommend that patients proposed for HTO be discriminated by eFI, and patients with higher scores should be cautiously selected.

20-Year Outcomes of High Tibial Osteotomy: Determinants of Survival and Functional Outcome

Background: High tibial osteotomy (HTO) is a successful joint-preserving procedure for the treatment of medial compartment osteoarthritis. Long-term survivorship of HTO ranges from 40% to 85%. There are consistent factors that predict failure. Purpose: To determine the 20-year survival of HTO and identify predictors of failure. Study Design: Case series; Level of evidence, 4. Methods: A total of 100 consecutive patients with medial bone-on-bone arthritis were prospectively studied to provide long-term patient-reported outcome measures after lateral closing-wedge HTO and determine the time to failure. Failure was defined as conversion to arthroplasty (total knee arthroplasty or unicompartmental knee arthroplasty) or revision HTO. Results: At 20 years, HTO survival was determined in 95 patients, and 5 were lost to follow-up. The overall survivorship of HTO at 20 years was 44%. The significant factors that were associated with better survivorship were age <55 years, body mass index <30, and Western Ontario and McMaster Universities Osteoarthritis Index pain score >45. These factors were used to define the favorable candidates. In the favorable candidates, survivorship was 100% at 5 years, after which there was a gradual decline to 62% survival at 20 years. Of those with HTO survival, 32 of 33 (97%) reported satisfaction with surgery, with a mean Knee injury and Osteoarthritis Outcome Score Pain score of 91 and Activities of Daily Living score of 97. Conclusion: HTO is a successful surgical option to treat medial compartment osteoarthritis and prevent the need for arthroplasty in young patients. The most suitable candidates for HTO are aged <55 years, are not obese, and have not progressed to severe symptomatic disability.

Early results of high tibial osteotomy versus combined arthroscopic surgery.

To investigate the early effect of high tibial osteotomy (HTO) compared with combined arthroscopic surgery. A retrospective study was conducted on patients who underwent HTO at The First Affiliated Hospital of Shandong First Medical University from January 2018 to January 2022. 138 patients (163 knees) with knee osteoarthritis (KOA) treated with HTO were selected. The medial proximal tibial angle (MPTA), joint line convergence angle (JLCA), femoral tibial angle (FTA), hip-knee-ankle (HKA) angle, weight-bearing line (WBL) ratio of the knee joint, opening gap, opening angle, American Knee Society score (KSS), US Hospital for Special Surgery (HSS) score, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score were measured to determine the different effects between HTO and HTO combined with arthroscopic by logistic regression analysis. Patients with HTO combined with arthroscopic surgery have improved functional scores as well as imaging perspectives compared to preoperative. By multivariate logistic analysis, it was concluded that arthroscopic surgery and gender are influential factors in the outcome of HTO surgery. The postoperative KSS score was 2.702 times more likely to be classified as excellent in the HTO combined with arthroscopy group than in the HTO group [Exp (β) = 2.702, 95% CI (1.049-6.961), P = 0.039]; the postoperative KSS score was 0.349 times more likely to be classified as excellent in women than in men [Exp (β) = 0.349, 95% CI (0.138-0.883), P = 0.026]. Better results with HTO combined with arthroscopic surgery. HTO combined with arthroscopy is a better choice in the surgical treatment of KOA.

Functional outcomes of high tibial osteotomy for symptomatic medial compartment osteoarthritis in middle-aged patients-both prospective and retrospective study in Indian population in the quaternary care center

Functional outcomes of high tibial osteotomy for symptomatic medial compartment osteoarthritis in middle-aged patients-both prospective and retrospective study in Indian population in the quaternary care center

Surgical accuracy of coronal and sagittal alignment in conventional closed-wedge high tibial osteotomy after computer-assisted surgery experience

BackgroundAlthough intraoperative navigation can improve the surgeon’s proficiency, no studies have analyzed postoperative outcomes of high tibial osteotomy (HTO) after computer-assisted surgery (CAS) experience. The present study compared the clinical and radiographic results between conventional and CAS closed-wedge (CW) HTOs after CAS experience.MethodsEach of the 50 conventional and CAS CW HTOs performed by single surgeon between 2015 and 2017 were included. The surgeon had experience of 140 cases of CAS CW HTOs before the study period. The groups were not different in terms of demographics. Clinically, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and range of motion (ROM) were investigated. Radiographically, the mechanical axis (MA), change in posterior tibial slope angle (PTS), and parallel angle were evaluated. The proportions of inlier groups for the postoperative MA (within valgus 2° ± 3°), change in the PTS (within ± 3°), and parallel angle (< 3°) were compared.ResultsThere were no significant differences in postoperative clinical results between the conventional and CAS groups. The MA was appropriately corrected in both groups (2.4° versus 2.9°, p = 0.317). The amount of change in PTS was significantly greater in the conventional group (−2.2° versus −0.8°, p = 0.018). The parallel angle was 5.3° in the conventional groups and 3.1° in the CAS group (p = 0.003). The proportion of inlier group was not significantly different in the postoperative MA (72% versus 78%) and change in the PTS (52% versus 66%). The proportion of inlier for the parallel angle was significantly lower in the conventional group (36% versus 60%, p = 0.027).ConclusionsThe surgical proficiency after CAS experience could cover the advantages of an intraoperative navigation in coronal adjustment, not in the sagittal adjustments in CW HTOs. A larger cohort with multiple surgeons in multiple centers would be required to identify the general trend.Study designLevel of evidence III.

Unicompartmental Knee Arthroplasty Provides Superior Clinical and Radiological Outcomes Compared to High Tibial Osteotomy at a Follow-Up of 5-8 Years.

Knee Osteoarthritis (OA) is a debilitating disease. Initially, the medial compartments are affected in most cases. For this pathology, joint preservation is preferable. Two surgical procedures aim to meet this goal: high-tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA). The aim was to compare clinical and radiological outcomes of HTO versus UKA in patients with unicompartmental, medial OA. Retrospective case series. A total of 86 (61 UKA, 25 HTO) patients that received either treatment at a single, specialized center were assessed pre-operatively and at a single follow-up examination at 77.13 months (±8.170). The Knee Society Score (KSS), range of motion (ROM), SF36 questionnaire and the Tegner score were used. The Kellgren-Lawrence score was assessed pre- and post-surgically. Survivorship with the endpoint "revision" was assessed. The UKA group showed significantly better improvements in KSS scores for pain (p < 0.006) and function (p < 0.001). OA progression (p < 0.02) and survivorship (p < 0.018) differed, significantly favoring UKA. ROM, SF36 and Tegner score did not differ significantly. The presented mid-to long-term data suggest that UKA provides superior results in selected outcomes. Nevertheless, significant differences in the demographics of treatments indicate the challenge of comparing these two treatments.

Adipose-Derived Stromal Vascular Fractions Are Comparable With Allogenic Human Umbilical Cord Blood–Derived Mesenchymal Stem Cells as a Supplementary Strategy of High Tibial Osteotomy for Varus Knee Osteoarthritis

To compare the clinical, radiologic, and second-look arthroscopic outcomes of high tibial osteotomy (HTO) with stromal vascular fraction (SVF) implantation versus human umbilical cord blood-derived mesenchymal stem cells (hUCB-MSC) transplantation and identify the association between cartilage regeneration and HTO outcomes. Patients treated with HTO for varus knee osteoarthritis between March 2018 and September 2020 were retrospectively identified. In this retrospective study, among 183 patients treated with HTO for varus knee osteoarthritis between March 2018 and September 2020, patients treated with HTO with SVF implantation (SVF group; n= 25) were pair-matched based on sex, age, and lesion size with those who underwent HTO with hUCB-MSC transplantation (hUCB-MSC group; n= 25). Clinical outcomes were evaluated using the International Knee Documentation Committee score and Knee Injury and Osteoarthritis Outcome Score. Radiological outcomes evaluated were the femorotibial angle and posterior tibial slope. All patients were evaluated clinically and radiologically before surgery and during follow-up. The mean final follow-up periods were 27.8 ± 3.6 (range 24-36) in the SVF group and 28.2 ± 4.1 (range, 24-36) in the hUCB-MSC group (P= 0.690). At second-look arthroscopic surgery, cartilage regeneration was evaluated using the International Cartilage Repair Society (ICRS) grade. A total of 17 male and 33 female patients with a mean age of 56.2 years (range, 49-67 years) were included. At the time of second-look arthroscopic surgery (mean, 12.6 months; range, 11-15 months in the SVF group and 12.7 months; range, 11-14 months in the hUCB-MSC group, P= .625), the mean International Knee Documentation Committee score and Knee Injury and Osteoarthritis Outcome Score in each group significantly improved (P < .001 for all), and clinical outcomes at final follow-up further improved in both groups when compared with the values at second-look arthroscopic surgery (P < .05 for all). Overall ICRS grades, which significantly correlated with clinical outcomes, were similar between groups with no significant differences (P= .170 for femoral condyle and P= .442 for tibial plateau). Radiologic outcomes at final follow-up showed improved knee joint alignment relative to preoperative conditions but showed no significant correlation with clinical outcomes or ICRS grade in either group (P > .05 for all). Improved clinical and radiological outcomes and favorable cartilage regeneration were seen after surgery for varus Knee OA in both SVF and hUCB-MSC groups. Level III, retrospective comparative study.

Bone Grafting Outcomes in Smokers Undergoing High Tibial Osteotomy: A Systematic Review.

This systematic review summarises the findings in the literature available to show outcomes of high tibial osteotomy (HTO) withbone grafting in smokers. It also studies the trend of complications, outcome measures used and overall outcomes like union, non-union or the need to perform revision surgeries. The aim is to find out if HTO done with bone graftingimproves outcomes in smokers. Articles were shortlisted using Population, Intervention, Control, and Outcomes (PICO) search design and quality assessment was completed using Jadad, STROBE (Strengthening the Reporting of Observational studies in Epidemiology), Delphi, and Critical Appraisal Skills Program (CASP) followed by data extraction by two independent authors. There was union in 97.6% of smokers who received HTO with bone grafting. A case of non-union was treated with removal of metalwork and distraction osteogenesis. Three cases of unknown demographics had arthroplasty in the time frame from HTO with bone grafting to follow up. The commonest complication post surgery was metalwork causing soft tissue irritation and lateral proximal tibial cortex fracture. Following this review we can conclude that HTO with bone grafting could be considered as an optionto achieve better outcomes in smokers. Bone grafting helps healing across osteotomy sites in smokers whose healing potential is poor. Autogenous Iliac crest bone grafting is ideal due to its osteoinductive and osteoconductive properties, but has the disadvantage of donor site morbidity.

TWENTY-YEAR SURVIVAL OF HIGH TIBIAL OSTEOTOMY

The aim of this study was to determine the long term 20 year survival and outcomes of high tibial osteotomy (HTO).100 consecutive subjects underwent HTO under the care of a single surgeon between 2000 and 2002, consented to participation in a prospective study and completed preoperative WOMAC scores. Subjects were reviewed at 10 years, and again at a minimum of 20 years after surgery. PROMS included further surgery, WOMAC scores, Oxford Knee Score (OHS), KOOS, and EQ-5D, and satisfaction with surgery. 20 year survival was assessed with Kaplan-Meir analysis, and failure defined as proceeding to subsequent knee arthroplasty.The mean age at HTO was 50 years (range 26-66), and 72% were males. The 5, 10, and 20 year survival of the HTO was 88%, 76%, 43% respectively. On multiple regression analysis HTO failure was associated with poor preoperative WOMAC score of 45 or less (HR 3.2, 95% CI 1.7-6.0, p=0.001), age at surgery of 55 or more (HR 2.3, 95% CI 1.3-4.0, p=0.004), and obesity (HR 1.9, 95% CI 1.1-3.4, p=0.023). In patients who met all criteria of preoperative WOMAC score of 45 or less, age &lt;55 years and body mass index of &lt;30 HTO survival was 100%, 94%, and 59% at 5, 10 and 20 years respectively. Of those who had not proceeded to TKA the mean Oxford Score was 40, KOOS Pain score was 91 and KOOS function score was 97. 97% reported they were satisfied with the surgery and 88% would have the same surgery again under the same circumstances.At 20 years after HTO 43% had not proceeded to knee arthroplasty, and were continuing to demonstrate high subjective scores and satisfaction with surgery. HTO survival was higher in those under 55 years, with BMI &lt;30 and baseline WOMAC score of &gt;45 at 59% HTO survival over 20 years. HTO may be considered a viable procedure to delay premature knee arthroplasty in carefully selected subjects.

Cartilage regeneration techniques with concomitant high tibial osteotomy (HTO), An innovative biomechanical therapy for osteoarthritis (OA) knee – Systematic review

In orthopedic surgery, a high tibial osteotomy (HTO) is a common treatment. Indications, patient selection, pre-operative planning, surgical procedure, fixation methods, and complications are all covered in detail. This research concentrated on the factors that should be examined in order to produce positive long-term results. To examine the stated hypothesis “medium- to long-term outcomes of high tibial osteotomy and therapies for cartilage healing”. A thorough search of the database like MEDLINE was done. A clinical outcome investigation employing HTO as the main technique, the usage of a sort of cartilage repair, &amp; a minimum follow-up period of 2 years were all necessary. Everything from the research layout to the patient demographics to the sorts of procedures conducted, the clinical consequences to eventual overall knee arthroplasty progression and consequences was investigated in depth. As a result of a combination of HTO and cartilage regeneration procedures, patients may avoid or delay knee arthroplasty surgery in the medium to long term.

The Efficacy of High Tibial Osteotomy with or without Post-root Medial Meniscus Repair: A Systematic Review

Background: High tibial osteotomy (HTO) is a knee joint treatment modality for medial compartment arthritis, aiming to improve articular cartilage healing by shifting the lower limb’s axis. It is commonly used in younger patients with pain and active lifestyles, preventing advanced cartilage deterioration. Varus malalignment may often be accompanied with medial meniscus root tears. In recent years, meniscus root tears are often been repaired. However, the efficacy of medial meniscus repairs with high tibial in varus malalignment with medial meniscal tears remains a controversy. Purpose: The purpose is to study the functional outcomes of concurrent medial meniscus root repair with HTO versus HTO alone. Study design: Systematic review. Methods: According to Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines, we searched PubMed, Embase, Web of Science, and the Cochrane Library databases for studies reporting the outcomes of medial meniscus posterior root tear (MMPRT) repair with HTO versus HTO alone and extracted data about characteristics of patients, clinical functional scores, and radiologic outcomes. One reviewer extracted data and 1 reviewer assessed the risk of bias and performed a synthesis of the evidence. Articles were eligible if they reported the functional outcome of HTO alone or HTO and MMPRT repair in patients of varus malalignment and medial meniscus root tears. Results: 6 studies with 264 patients were identified. Data from these studies were segregated in HTO only and HTO with medial meniscus repair group. The findings of this systematic review suggest that the outcomes of HTO with MMPHRR and of only HTO are not statistically significant, meaning that doing valgus osteotomy only in patients with varus knee and MMPHRT can give good results regardless of not repairing the meniscus. Conclusion: HTO with medial meniscus posterior horn root repair seems to have no significant improvement in the functional outcomes of the patient. However, long-term studies need to be performed. Keywords: High tibial osteotomy, medial meniscus, root repair, arthroscopy, varus malalignment, meniscus, root tear

A prospective and retrospective study of the outcome of high tibial osteotomy in osteoarthritis of the knee with varus deformity

A prospective and retrospective study of the outcome of high tibial osteotomy in osteoarthritis of the knee with varus deformity

A Prospective Study of the Outcome of High Tibial Osteotomy in Osteoarthritis of Knee with varus Deformity

A Prospective Study of the Outcome of High Tibial Osteotomy in Osteoarthritis of Knee with varus Deformity

Distal tibial tubercle-high tibial osteotomy with assistance of modifiable spreader in the treatment of varus knee osteoarthritis: A retrospective observational study

As one of the knee preservation surgical approaches, good clinical outcomes of high tibial osteotomy were reported. Aims of this study were to analyze the clinical outcome and pre- and postoperative radiographical parameter and knee functional score between distal tibial tubercle high tibial osteotomy (DTTHTO) and open wedge- high tibial osteotomy (OWHTO) in patients with varus knee osteoarthritis after more than 1 year following-up. A total of 194 consecutive patients in our joint center from March 2016 to October 2021 were enrolled, according to the surgical method, patients were divided into DDTHTO and OWHTO groups. Radiographic parameters of Kellgren-Lawrence grading, hip-knee-ankle angle, weight bearing line ratio and medial tibial plateau angle, knee functional score of American knee society (AKS) score, western Ontario and McMaster universities arthritis index (WOMAC) score, visual analogue score (VAS) were introduced to evaluate clinical outcome for patients who received DDTHTO and OWHTO. There were 103 knees and 89 knees in the OWHTO and DTTHTO group, respectively. Mean weight bearing line ratio for OWHTO and DTTHTO were 25.1 ± 11.7 and 25.2 ± 12.0% respectively, medial tibial plateau angle and hip-knee-ankle angle angle demonstrated that all patients in the present study inherited a varus angle ranges from 3.4° to 9.5°. Preoperative AKS, WOMAC and VAS were 68.4 ± 5.7 versus 69.0 ± 5.9, 109.3 ± 15.0 versus 107.7 ± 14.0 and 6.8 ± 1.0 versus 6.9 ± 0.8, and there was no significant difference between 2 groups (P > .05). Mean postoperative AKS and WOMAC score for patients in both OWHTO and DTTHTO group were significantly improved, moreover, postoperative VAS of DTTHTO patients was lower than that in OWHTO group (P < .05). When comparing the operation time, intraoperative blood loss and bone union time, DHHTO group shows a superiority in these variables over patients in OWHTO (121 ± 29.6 vs 145.7 ± 35.2 minutes, 115.0 ± 20.8 vs 103.3 ± 17.3 mL, 13.7 ± 4.1 vs 12.0 ± 2.8 weeks; P < .005) and incidence of complication was lower for DTTHTO group. DTTHTO in patients with varus knee osteoarthritis has good clinical outcomes, and it can achieve a better postoperative alignment. Operation time and surgical trauma were also less in patients who underwent DTTHTO.

Mid-Term Results of High Tibial Osteotomy Regarding From Grades of Knee Osteoarthritis

Objectives: The number of high tibial osteotomy (HTO) has significantly increased in Mongolia, however, researchers are still debating about the impact of severity of knee osteoarthritis on the outcome of high tibial osteotomy. The purpose of our study is to report the mid-term results of HTO for knee osteoarthritis according to the Kellgren Lawrence classification. Methods: A total of 100 patients who underwent high tibial osteotomy for knee osteoarthritis from October 2019 to June 2020 at the Joint Center of the First Central Hospital of Mongolia participated in this study. Outcome evaluation of the participants was accomplished at baseline, at 2 months, 6 months, 8 months and 18 months post-operatively. Results: Lateral closing wedge HTO was performed in 54.2 % of patients who had 1st grade deformity and 55.9 % of patients who had 2nd grade deformity. On the other hand, medial opening wedge HTO was performed in 3rd grade patients compared to other grades. WBL was 11.43 ± 8.22 at preoperative, and increased to 56.31 ± 4.52 after 12 months of the surgery in 3rd grade. The total WBL was improved from 20.54 ± 12.57 to 57.24 ± 3.69 after two months of surgery and 57.89 ± 4.17 after 12 months. Conclusion: Our study showed that the severity of knee osteoarthritis had impact on outcome of high tibial osteotomy.

Patellofemoral cartilage defects are acceptable in patients undergoing high tibial osteotomy for medial osteoarthritis of the knee

BackgroundPatients suffering cartilage defects of the medial compartment with underlying varus deformity do benefit from high tibial osteotomy (HTO) even in the long term. Nonetheless, kinematic and geometric changes especially in the patellofemoral joint have been described.Purpose of the present study was to evaluate the influence of patellofemoral cartilage defects detected during the diagnostic arthroscopy and their influence on HTO’s postoperative outcome.MethodsNinety patients with a mean follow-up of 10.08 ± 2.33 years after surgery were included. Patients were divided into four groups according to their cartilage status in the patellofemoral joint (A = no defects, B = isolated lesions of the patella, C = isolated lesions of the trochlea, D = kissing lesions). Functional outcome was evaluated before surgery and about ten years thereafter by relying on the IKDC, Lysholm, and KOOS scores. Radiological parameters were assessed pre- and six weeks postoperatively.ResultsIn groups A to D, the HTO led to significant patellar distalisation in the sagittal view, with the mean indices remaining at or above the limit to a patella baja. All patients in all groups profited significantly from HTO (higher Lysholm score, lower VAS p < 0.001), patients in group D had the lowest outcome scores. Patella height negatively influenced outcome scores in group C (Blackburne-Peel-Index—VAS p = 0.033) and D (Caton-Deschamps-Index—Tegner p = 0.018), a larger valgus correction was associated with lower outcome scores in group D (Lysholm p = 0.044, KOOSpain 0.028, KOOSQOL p = 0.004).ConclusionLong-term results of HTO for varus medial compartment osteoarthritis remain good to excellent even in the presence of patellofemoral defects. Overcorrection should be avoided. Distal biplanar HTO should be considered for patients presenting trochlear or kissing lesions of the patellofemoral joint.Trial registrationDRKS00015733 in the German Registry of Clinical Studies.

High Tibial Osteotomy versus Proximal Fibular Osteotomy in Medial Compartmental Osteoarthritis of Knee: A Longitudinal Study

Introduction: Osteoarthritis (OA) is a chronic degenerative intra-articular disorder of cartilage and bone. Knee joint is most commonly involved due to its pivotal role in weight bearing as it is constantly exposed to wear and tear. Osteotomy procedures can achieve normal alignment of the weight bearing axis of the lower limbs. Aim: To evaluate and compare the functional outcome of High Tibial Osteotomy (HTO) and Proximal Fibular Osteotomy (PFO) in medial compartmental osteoarthritis of knee joint. Materials and Methods: This prospective longitudinal study was conducted in a tertiary healthcare centre, IPGMER and SSKMH, Kolkata,West Bangal, India from October 2019 to November 2021 for a duration of 26 months, in which 40 osteotomies were performed around the knee. Considering the inclusion and exclusion criteria 20 proximal fibular osteotomies and 20 high tibial osteotomies were operated avoiding the patients with advanced stage or tricompartmental OA. The scoring system considered for evaluation of the functional outcome was Oxford Knee Score (OKS) and Visual Analouge Scale (VAS) Score. The analysis was done through paired t-test with determining of p-value where value ≤0.05 was considered for statistically significant. Results: Majority of the patients in the present study were more than 45 years of age. The most frequent age group was 46-50 years followed by 51-55 years. The follow-up period was at least 15 months where the OKS score was 39.35±3.51 and 41.20±4.50 with p-value of 0.1556 and VAS score was 5.50±1.10 and 3.80±1.10 with p value of &lt;0.0001 for PFO and HTO respectively. Only two of the patients developed surgical site infection in both cases. Conclusion: In long term follow-up the final functional status of both treatment modalities were comparable although HTO was considered superior with significant improvement in pain relief perspective than PTO.

Our results of high tibial osteotomy in medial knee osteoarthritis

Our results of high tibial osteotomy in medial knee osteoarthritis

Comparative study between functional outcome of high tibial osteotomy and partial fibulectomy in isolated medial compartment osteoarthritis of knee

Purpose: To compare the results of high tibial osteotomy with partial fibulectomy in the surgical management of isolated medial compartment osteoarthritis of knee and to reduce pain and deformity. Methods: patients visiting the outpatient department of S.C.S.M.S.R. with complaints of knee pain. Patients who were found to have isolated medial compartment osteo-arthritis will be included in the study. 50 patients were subjected to high tibial osteotomy and 50 patients were operated with partial fibulectomy. Functional outcome of both the procedure were compared with WOMAC score. Patients were followed up at 3 months 6 months and 9 months and reassessed. Result: There were a total of 100 patients with clinically and X-ray confirmed medial compartment osteoarthritis of knee (41 males and 59 females) with most patient in 51-60 year age group. mean pre operative WOMAC score was 82.38 and mean post operative score at 9 Month follow up was 38.43(p value