Analysis of Outcomes for High Tibial Osteotomies Performed With Cartilage Restoration Techniques
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- 作者：Cynthia A. Kahlenberg ; M.D.a ; kahlenbergc@hss.edu ; Benedict U. Nwachukwu ; M.D.a ; Kamran S. Hamid ; M.D. ; M.P.H.b ; Michael E. Steinhaus ; M.D.a ; Riley J. Williams III ; M.D.a
- 刊名：Arthroscopy: The Journal of Arthroscopic & Related Surgery
- 出版年：2017
- 出版时间：February 2017
- 年：2017
- 卷：33
- 期：2
- 页码：486-492
- 全文大小：383 K
- 卷排序：33
文摘
To evaluate reported medium- to long-term outcomes after high tibial osteotomy (HTO) with associated cartilage restoration procedures.MethodsA review of the MEDLINE database was performed. The inclusion criteria were English language, clinical outcome study with HTO as the primary procedure, use of a form of cartilage repair included, and the mean follow-up period of at least 2 years. Each identified study was reviewed for study design, patient demographics, type of procedures performed, clinical outcomes, progression to total knee arthroplasty, and complications.ResultsEight hundred and twenty-seven patients (839 knees) were included. The most common cartilage preservation technique used in conjunction with HTO was microfracture (4 studies; 22.2%). The mean Lyscholm scores, reported in 50% of the studies, ranged from 40 to 65.7 preoperatively and improved to a range of 67 to 94.6 postoperatively. Four studies (22.2%) used a visual analog scale for evaluation of pain and all had a mean visual analog scale of less than 3 postoperatively. Among studies evaluating conversion to arthroplasty, the rate of conversion was 6.8% and the range of mean number of years from HTO to conversion was 4.9 to 13.0. The overall reported complication rate was 10.3%.ConclusionsHTO with cartilage restoration procedures provides reliable improvement in functional status in the medium- to long-term period after surgery and has potential to delay or avoid the need for knee arthroplasty surgery.Level of EvidenceLevel IV, systematic review of Level I to IV studies.