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- Title
Cartilage regeneration is related to superior mid‐term patient‐reported outcomes after open‐wedge high tibial osteotomy.
- Authors
Tsushima, Takahiro; Sasaki, Eiji; Sakamoto, Yukiko; Kimura, Yuka; Tsuda, Eiichi; Ishibashi, Yasuyuki
- Abstract
Purpose: Medial open‐wedge high tibial osteotomy (OWHTO) is related to cartilage improvement in the medial compartment. This study aimed to evaluate factors associated with cartilage improvement and patient‐reported outcomes (PRO) after OWHTO. It was hypothesised that cartilage improvement is associated with favourable PRO. Methods: This retrospective study included 94 patients who underwent OWHTO. The mean follow‐up period was 5 years. The weight‐bearing line ratio (WBLR) was defined as the ratio of the distance from the medial tibial edge to the tibial insertion of the weight‐bearing line and the tibial width. The International Cartilage Research Society grade evaluated the medial femoral condyle (MFC) and medial tibial plateau (MTP) at initial and second‐look arthroscopy, and cartilage improvement after OWHTO was assessed. Postoperative knee injury and osteoarthritis outcome scores (KOOS) were compared between the groups with improved and non‐improved cartilage. Additionally, factors related to cartilage improvement and postoperative KOOS scores were analysed. Results: Regarding the MFC, KOOS pain, symptoms, activities of daily living (ADL) and quality of life (QOL) were significantly higher in the cartilage‐improved group than in the non‐improved group (p = 0.012, 0.003, 0.001, 0.006), and cartilage improvement was significantly related to KOOS pain, ADL and QOL (p = 0.021, 0.039, 0.013). In addition, the postoperative WBLR was associated with cartilage improvement, with a cutoff value of 54.0% (p = 0.046). Regarding the MTP, KOOS ADL and QOL (p = 0.026, 0.022) were significantly higher in the cartilage‐improved group than in the nonimproved group. Body mass index (BMI) was significantly related to the postoperative QOL (p = 0.018) and associated with cartilage improvement, with a cutoff value of 25.9 kg/m2 (p = 0.002). Conclusion: A postoperative WBLR greater than 54.0% and a preoperative BMI below 25.9 kg/m2 were associated with cartilage improvement, positively impacting PRO after OWHTO. Level of Evidence: Level III, retrospective comparative study.
- Subjects
CARTILAGE regeneration; PATIENT reported outcome measures; KNEE injuries; SURGICAL complications; OSTEOTOMY; BODY mass index
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2024, Vol 32, Issue 3, p725
- ISSN
0942-2056
- Publication type
Article
- DOI
10.1002/ksa.12091