Outcome after high tibial open-wedge osteotomy: a retrospective evaluation of 533 patients

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• 作者：Stephanie Floerkemeier (1)
  Alex E. Staubli (2)
  Steffen Schroeter (3)
  Sabine Goldhahn (4)
  Philipp Lobenhoffer (5)
  
• 关键词：Open ; wedge osteotomy ; High tibial osteotomy ; Medial osteoarthritis ; Oxford Knee Score ; Joint ; preserving technique ; Tomofix plate fixator
• 刊名：Knee Surgery, Sports Traumatology, Arthroscopy
• 出版年：2013
• 出版时间：January 2013
• 年：2013
• 卷：21
• 期：1
• 页码：170-180
• 全文大小：394KB
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• 作者单位：Stephanie Floerkemeier (1)
  Alex E. Staubli (2)
  Steffen Schroeter (3)
  Sabine Goldhahn (4)
  Philipp Lobenhoffer (5)
  
  1. Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany
  2. Private Clinic Sonnmatt Luzern, Hemschlennstrasse, Postfach, 6000, Luzern 15, Switzerland
  3. BG Unfallklinik Tübingen, Schnarrenbergstr. 95, 72076, Tübingen, Germany
  4. AO Clinical Investigation and Documentation, AO Center, Stettbachstr. 10, 8600, Dübendorf, Switzerland
  5. Sports Clinic Germany, Uhlemeyerstr. 16, 30175, Hannover, Germany
  
• ISSN：1433-7347

文摘

Purpose Open-wedge valgus high tibial osteotomy is a well-established procedure in the management of medial osteoarthritis of the knee. In recent years, improved osteotomy and fixation methods have led to an increased use of this technique. The aim of this study was to identify predictive parameters for the clinical outcome after valgus high tibial osteotomy. Methods A multicentre case series involving retrospective capture of baseline data and prospective outcome assessment of patients with knee OA who underwent an osteotomy using Tomofix? plate was conducted. Functional outcome was assessed using Oxford 12-item Knee Score. Results Before surgery, the majority of patients had grade III (52?%) and grade IV (33?%) lesions according to Outerbridge classification. Three hundred and eighty-six of 533 eligible patients were interviewed for follow-up after an average of 3.6?years. The mean Oxford Knee Score was 43 points. Six per cent experienced at least one local postoperative complication. There was a tendency towards lower score results in patients with a higher preoperative degree of the medial cartilage lesion. No correlation between patient age and the Oxford Knee Score was observed. Conclusion Being male, being operated by an experienced surgeon, having no intake of pain medication at follow-up and having no postoperative complication are positive predictors of the Oxford Knee Score up to 5?years after surgery. This study reveals favourable midterm results after valgus high tibial osteotomy in varus osteoarthritis, even in older patients with high degree of cartilage damage. Level of evidence II.