Closing-wedge high tibial osteotomy: survival and risk factor analysis at long-term follow up

BMC Musculoskeletal Disorders

Research Article

Bernd Ishaque¹  Stefan Lakemeier²  Thomas J Heyse²  Susanne Fuchs-Winkelmann²  Gafar Ahmed²  Markus D Schofer²  Turgay Efe²  Ulrich Boudriot³  Nina Timmesfeld⁴ 

[1] Clinic and Polyclinic for Orthopaedic Surgery, University Hospital Giessen, Paul Meimberg Str. 3, 35392, Giessen, Germany;Department of Orthopaedics and Rheumatology, University Hospital Marburg, 35043, BaldingerstrasseMarburg, Germany;Department of Orthopaedics, Sankt Elisabeth Hospital, Stadtring Kattenstroth 130, 33332, Gütersloh, Germany;Institute of Medical Biometry and Epidemiology, Philipps-University Marburg, Bunsenstrasse 3, 35037, Marburg, Germany;

关键词: Total Knee Arthroplasty;    High Tibial Osteotomy;    Opening Wedge High Tibial Osteotomy;    Wedge High Tibial Osteotomy;    Varus Malalignment;   

DOI  :  10.1186/1471-2474-12-46

 received in 2010-09-23, accepted in 2011-02-14,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundClosing-wedge high tibial osteotomy (HTO) is successful for the treatment of medial osteoarthritis with varus malalignment. Preoperative risk factors for HTO failure are still controversial. The aim of this study was to elucidate the outcome and assess the influence of risk factors on long term HTO survival.Methods199 patients were retrospectively studied with a mean follow-up period of 9.6 years after HTO. HTO failure was defined as the need for conversion to TKA. Survival was analyzed with the Kaplan-Meier method. Knee function was evaluated by the Hospital for Special Surgery (HSS) score. HTO-associated complications were also assessed. Univariate, multivariate, and logistic regression analysis were performed to evaluate the influence of age, gender, BMI, preoperative Kellgren-Lawrence osteoarthritis grade, and varus angle on HTO failure.Results39 complications were recorded. Thus far, 36 HTOs were converted to TKA. The survival of HTO was 84% after 9.6 years. Knee function was considered excellent or good in 64% of patients. A significant preoperative risk factor for HTO failure was osteoarthritis, Kellgren-Lawrence grade >2.ConclusionHTO provides good clinical results in long-term follow-up. Preoperative osteoarthritis Kellgren-Lawrence grade >2 is a significant predictive risk factor for HTO failure. Results of HTO may be improved by careful patient selection. Complications associated with HTO should not be underestimated.

【 授权许可】

CC BY   
© Efe et al; licensee BioMed Central Ltd. 2011