Responders to Medial Opening Wedge High Tibial Osteotomy for Knee Osteoarthritis.

Autor:	Primeau CA; C.A. Primeau, PhD, T.B. Birmingham, PhD, Fowler Kennedy Sport Medicine Clinic, Western University, School of Physical Therapy, Faculty of Health Sciences, Western University, and Bone and Joint Institute, Western University., Birmingham TB; C.A. Primeau, PhD, T.B. Birmingham, PhD, Fowler Kennedy Sport Medicine Clinic, Western University, School of Physical Therapy, Faculty of Health Sciences, Western University, and Bone and Joint Institute, Western University., Appleton CT; C.T. Appleton, MD, PhD, Bone and Joint Institute, Western University, and Department of Medicine, Schulich School of Medicine and Dentistry, Western University; tom.appleton@sjhc.london.ca., Leitch KM; K.M. Leitch, PhD, P.J. Fowler, MD, Fowler Kennedy Sport Medicine Clinic, Western University., Fowler PJ; K.M. Leitch, PhD, P.J. Fowler, MD, Fowler Kennedy Sport Medicine Clinic, Western University., Marsh JD; J.D. Marsh, PhD, School of Physical Therapy, Faculty of Health Sciences, Western University, and Bone and Joint Institute, Western University., Giffin JR; J.R. Giffin, MD, MBA, Fowler Kennedy Sport Medicine Clinic, Western University, Bone and Joint Institute, Western University, and Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	The Journal of rheumatology [J Rheumatol] 2023 Jun; Vol. 50 (6), pp. 809-816. Date of Electronic Publication: 2023 Feb 15.
DOI:	10.3899/jrheum.220956
Abstrakt:	Objective: Medial opening wedge high tibial osteotomy (HTO) aims to improve symptoms for patients with knee osteoarthritis (OA) and varus alignment, yet the likelihood of achieving a minimum clinical threshold of response and the factors predictive of response are unclear. We evaluated the proportion of patients meeting responder criteria based on the Outcome Measures in Rheumatology-Osteoarthritis Research Society International consensus 2 years after medial opening wedge HTO and investigated predictors of response. Methods: Patients in a prospective cohort with symptomatic knee OA and varus alignment completed the Knee Injury and Osteoarthritis Outcome Score questionnaire < 3 months before and 2 years after HTO. For our primary analysis, we calculated the proportion of responders with ≥ 20% relative improvement and an absolute change of ≥ 10 points in pain and function from baseline. We performed logistic regression to evaluate the association of predictors with response and completed sex-disaggregated analyses. Results: At a mean of 20.3 (SD 6.2) months post-HTO, 406 patients (78%) met the responder criteria. Older age, higher BMI, and larger postoperative mechanical axis angles (ie, slight valgus) were associated with increased odds of achieving responder criteria, although odds ratios were small. When stratified by sex, 316/405 male patients (78%) and 90/118 female patients (76%) met the responder criteria. Conclusion: Based on responder criteria for knee OA, 78% of patients undergoing medial opening wedge HTO were responders at 2 years postsurgery. Although patients who are younger, male, and nonobese are viewed as appropriate candidates for HTO, patients who are female, are older, and have a high BMI also achieve sizable improvements in pain and function. (Copyright © 2023 by the Journal of Rheumatology.)
Databáze:	MEDLINE
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