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

Autor:	Constantin H; North Sydney Orthopaedic and Sports Medicine Centre, Wollstonecraft, Australia., Salmon LJ; North Sydney Orthopaedic and Sports Medicine Centre, Wollstonecraft, Australia.; School of Medicine, University of Notre Dame, Sydney, Australia., Russell V; School of Medicine, University of Notre Dame, Sydney, Australia., Sundaraj K; North Sydney Orthopaedic and Sports Medicine Centre, Wollstonecraft, Australia., Roe JP; North Sydney Orthopaedic and Sports Medicine Centre, Wollstonecraft, Australia.; School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia., Pinczewski LA; North Sydney Orthopaedic and Sports Medicine Centre, Wollstonecraft, Australia.; School of Medicine, University of Notre Dame, Sydney, Australia.
Jazyk:	angličtina
Zdroj:	The American journal of sports medicine [Am J Sports Med] 2024 Feb; Vol. 52 (2), pp. 344-351. Date of Electronic Publication: 2024 Jan 20.
DOI:	10.1177/03635465231217742
Abstrakt:	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. Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: This study was supported by the Friends of the Mater Foundation, Sydney, Australia. J.P.R. has received consulting fees from Smith & Nephew and Pureplay Orthopaedic and nonconsulting fees from 360 Medcare. He holds stock or stock options in 360 Medcare. L.A.P. has received research support from Smith & Nephew and IP royalties from Australian Biotechnologies. He holds stock or stock options in Australian Biotechnologies. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.
Databáze:	MEDLINE
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