I. Choi (Gwangju, KR)

Chonnam National University Bitgoeul Hospital

Presenter Of 1 Presentation

Podium Presentation Osteoarthritis

18.1.1 - Survival Analysis of Medial Open Wedge High Tibial Osteotomy for Unicompartment Knee Osteoarthritis: Long-term study

Presentation Number
18.1.1
Presentation Topic
Osteoarthritis
Lecture Time
14:15 - 14:24
Session Type
Free Papers
Corresponding Author
Disclosure
No Significant Commercial Relationship,No Significant Commercial Relationship

Abstract

Purpose

The purpose of this study was to evaluate the outcomes including survival rate and to analyze the factors that affect the survival rate after medial open wedge high tibial osteotomy (MOWHTO) performed as the primary treatment for medial unicompartmental osteoarthritis of the knee at a minimum follow-up

Methods and Materials

Out of 391 knees of MOWHTO performed between October 2003 and December 2009 at our institute, 339 knees with minimum follow-up period of five years were included in this retrospective analytical study. Clinical evaluation using Knee Society Score (KSS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and radiographic evaluation including Hip-Knee-Ankle angle were done preoperatively and postoperatively. Main failure criteria for survival were the conversion to total knee replacement or KSS<60 points. Also, risk factors that affected the survival after MOWHTO were analyzed.

Results

The mean KSS and WOMAC scores were significantly improved after surgery (87.3 and 18.5 at 5 years and 81.7 and 23.6 at 10 years, respectively). The mean HKA angle was corrected from 7.2° varus to 3.4° valgus after 1 year of surgery and remained until 10 years after surgery without significant differences (2.9° valgus at 5 years and 2.3° valgus at 10 years, p>0.05). Using the Kaplan-Meier survivorship estimate of failure, the probability of survival for MOWHTO was 96.8% at 5 years, 87.1% at 10 years, and 85.3% at 13 years. Of all factors analyzed using multivariate regression analysis, age≥65years (HR=2.52, p=0.034), medial compartment cartilage injury ICRS grade≥4 (HR=3.13, p=0.004), lateral compartment cartilage injury ICRS grade≥2 (HR=3.63, p=0.003), postoperative HKA angle<0° (HR=3.01, p=0.003) were associated with the failure.

Conclusion

The MOWHTO provided good survival at mid- to long-term follow-up. The old age, high-grade cartilage injury on medial and lateral compartment, under-correction of postoperative HKA angle appeared to be significant factors associated with the failure after MOWHTO .

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