Gait analysis following medial opening-wedge high tibial osteotomy

Morin, Vincent; Pailhé, Régis; Duval, Brice Rubens; Mader, R.; Cognault, Jérémy; Rouchy, R; Saragaglia, D.

doi:10.1007/s00167-017-4421-1

Cited by 18 publications

(17 citation statements)

References 44 publications

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“…Several authors report an improvement of clinical scores for up to 5 years postoperatively after HTO. The average postoperative Lysholm score is reported to range between 69 and 96 points and the mean SF-36 between 73 and 89 points [33][34][35][36][37][38]. Referring to those reports, the clinical results of our oHTO patients are within the upper range.…”

Section: Clinical Outcomesupporting

confidence: 61%

Tibial and femoral osteotomies in varus deformities - radiological and clinical outcome

Fürmetz

Patzler

Wolf

et al. 2020

BMC Musculoskelet Disord

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Background: Varus deformities of the knee are frequently corrected by osteotomies, which should be performed at the level of origin. But in contrast to high tibial osteotomies (HTO), little data exists for distal femoral osteotomies (DFO). This study evaluates radiological and clinical outcomes after valgisation osteotomies in the proximal tibia and distal femur. Methods: We used an observational cohort study design and prospectively performed preoperative long standing radiographs (LSR), lateral x-rays and clinical questionnaires (SF-36, Lysholm score, VAS). Postoperative LSR and lateral x-rays were obtained on average 18 months postoperative and postoperative clinical questionnaires at final visit (mean follow up 46 months). A subgroup analysis of the different surgical techniques (oHTO vs. cDFO) was performed, with regards to radiological and clinical outcomes. Results: Finally 28 osteotomies with medial tibial opening (oHTO) or lateral femoral closing (cDFO) wedge osteotomies in 25 consecutive patients (mean age 40 years) were identified. There were 17 tibal and 11 femoral procedures. All osteotomies were performed at the origin of deformity, which was of different etiology. The average deviation of the final HKA compared to the preoperative planning was 2.4°± 0.4°. Overall, there was a significant improvement in all clinical scores (SF-36: 61.8 to 79.4, p < 0.001; Lysholm-score: 72.7 to 90.4, p < 0.001; VAS: 3 to 1, p < 0.001). There was no significant correlation between surgical accuracy and outcome scores. Conclusion: Valgisation osteotomies lead to a significant improvement in all clinical scores with the demonstrated treatment protocol. An appreciable proportion of varus deformities are of femoral origin. Since cDFO provides comparable radiological and clinical results as oHTO, this is an important treatment option for varus deformities of femoral origin.

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Section: Clinical Outcomesupporting

confidence: 61%

Tibial and femoral osteotomies in varus deformities - radiological and clinical outcome

Fürmetz

Patzler

Wolf

et al. 2020

BMC Musculoskelet Disord

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“…The joint degeneration further results in a varus deformity with increasing load transmission through the already degenerate compartment [4]. Furthermore, knee joint loading and kinematics have been found to be altered in patients with early knee OA during gait [10].…”

Section: High Tibial Osteotomymentioning

confidence: 99%

“…The reported success rates of HTO are inconsistent with the long-term survivals and satisfaction of this procedure. Although a consensus is that ideal opening wedge HTO produces a decompression of the medial joint compartment, optimal amount of alignment correction of the lower limb remains unknown, which may result in the discrepancies among the surgeries [10]. Fujisawa et al [36, 41] recommended to align the WBL of HTO through the 65%–70% coordinate of the width of the tibial plateau, which has been refined recently to 62.5% (range 62% ∼ 66%).…”

Section: Alignment Principlementioning

confidence: 99%

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High Tibial Osteotomy: Review of Techniques and Biomechanics

Liu

Chen

Gao

et al. 2019

Journal of Healthcare Engineering

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High tibial osteotomy becomes increasingly important in the treatment of cartilage damage or osteoarthritis of the medial compartment with concurrent varus deformity. HTO produces a postoperative valgus limb alignment with shifting the load-bearing axis of the lower limb laterally. However, maximizing procedural success and postoperative knee function still possess many difficulties. The key to improve the postoperative satisfaction and long-term survival is the understanding of the vital biomechanics of HTO in essence. This review article discussed the alignment principles, surgical technique, and fixation plate of HTO as well as the postoperative gait, musculoskeletal dynamics, and contact mechanics of the knee joint. We aimed to highlight the recent findings and progresses on the biomechanics of HTO. The biomechanical studies on HTO are still insufficient in the areas of gait analysis, joint kinematics, and joint contact mechanics. Combining musculoskeletal dynamics modelling and finite element analysis will help comprehensively understand in vivo patient-specific biomechanics after HTO.

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“…Betrachtet man die detaillierte Analyse der einzelnen Subskalen, sind insbesondere eine dekompensierte Schmerzsituation (Subskala BP) sowie eine starke Einschränkung der körperlichen Funktionsfähigkeit (Subskala PF) zum Zeitpunkt der Indikationsstellung für den Übergang in eine Knieprothese relevant. [18,29]. Bastard et al zeigten analog zu unseren Ergebnissen eine signifikante Verbesserung 1,3 Jahre nach HTO anhand des SF-36 im mentalen sowie im psychischen Summenscore [30].…”

Section: Subjektive Gesundheitsbezogene Lebensqualitätunclassified

Health-Related Quality of Life – an Underestimated Factor to Evaluate the Treatment Success after Open Wedge HTO Surgery: Prospective 6-Years Follow-Up

Herbst

Kuwashima²,

Ahrend

et al. 2020

Z Orthop Unfall

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Background The subjective health related quality of life in patients with degenerative joint diseases is an important variable to evaluate the treatment outcome. In this study, mid-term results of open wedge HTO were analysed and compared to the subjective quality of life (SF 36) of the general population. Furthermore, the relationships of preoperative assessed subscales of the health-related quality of life (SF 36) and the conversion to knee arthroplasty were analysed. Methods The cohort consisted of 120 patients who were prospectively followed-up after open wedge HTO. At five follow-up points of time, patients were examined and asked about their subjective, health-related quality of life using the SF 36 score. Results 104 patients were included and evaluated until the last follow-up (mean: 81.2 ± 11.3 months after open wedge HTO; follow-up rate: 86.7%). Six years after open wedge HTO, similar values in several psychologic subscales of the SF 36 (BP, GH, V, MH) and the mental health component summary score (MCS) compared to the general population were found. The physical health component summary score (PCS) showed a significant improvement relative to the preoperative values. Nine out of 104 patients (8.7%) received a knee arthroplasty (50.1 ± 25.0 months). Low preoperative values of the subscales “physical functioning” (PF) and “bodily pain” (BP) were identified as risk factors in terms of conversion to a total knee arthroplasty. Conclusions Patients with medial unicompartimental knee osteoarthrosis treated with open wedge HTO showed very good results. The health-related quality of life was nearly as high as in the general population. Patients with preoperative low physical function and high pain values have a higher risk to have a conversion to knee arthroplasty. Surgeons should be aware of these factors if an open wedge HTO is considered.

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Gait analysis following medial opening-wedge high tibial osteotomy

Abstract: II.

Cited by 18 publications

References 44 publications

Tibial and femoral osteotomies in varus deformities - radiological and clinical outcome

Tibial and femoral osteotomies in varus deformities - radiological and clinical outcome

High Tibial Osteotomy: Review of Techniques and Biomechanics

Health-Related Quality of Life – an Underestimated Factor to Evaluate the Treatment Success after Open Wedge HTO Surgery: Prospective 6-Years Follow-Up

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