Preoperative overweight and obesity do not cause inferior outcomes following open-wedge high tibial osteotomy: A retrospective cohort study of 123 patients

Abstract

Open-wedge high tibial osteotomy (OWHTO) is effective in treating medial compartment osteoarthritis. The association between body mass index (BMI) and outcomes following OWHTO is being debated. This study compared radiographic and clinical outcomes between patients with preoperative overweight, obesity, and normal BMI following OWHTO for medial compartment osteoarthritis. In total, 123 patients (123 knees) who underwent OWHTO for medial compartment osteoarthritis were enrolled and were divided into normal-BMI (18.5−24.9 kg/m2), overweight (25−29.9 kg/m2), and obese (>30 kg/m2) groups based on body mass index. The numeric rating scale for pain, mechanical tibiofemoral angle (mTFA), tibia tilting angle (TTA), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for function were evaluated preoperatively and at postoperative follow-ups. The improvements of clinical and radiological outcomes in normal-BMI, overweight, and obese groups were not significantly different. The incidence of soft tissue irritation, wound infection, nonunion, and conversion to total knee arthroplasty were not significantly different between groups.The clinical and radiological outcomes in patients with preoperative overweight, obesity, and normal-BMI were not significantly different. Preoperative overweight and obesity thus has no effect on outcomes following OWHTO during the two years follow-up period. These findings cannot be generalized to patients with morbid obesity.

The effects on joint functions of biplanar distal tubercle open-wedge high tibial osteotomy: A prospective study

“…Therefore, no correlation was determined between BMI and the development of complications or conversion to TKA. Similarly, in a study with a 2-year follow-up, Wu et al [17] reported that there was no correlation between BMI values and conversion to TKA, the development of complications, or clinical, functional, and radiological healing.…”

Is there an indication for simultaneous bilateral knee arthroplasty in morbidly obese patients? Should the patients’ request for simultaneous operation be considered?

“…While SBTKA surgery is still a matter of debate among orthopedists, there are serious concerns about performing SBTKA to O and MO patients. Obesity is a strong risk factor for bilateral osteoarthritis of the knees [6][7][8]. Close to 40% of the world population and 900 million people worldwide are obese, and the numbers increase daily.…”

“…Superficial fat necrosis and WHP are common in MO patients [ 5 ]. Due to the negative effects of obesity on the immune system and decreased subcutaneous tissue oxygenation, the rate of infection development in these patients is quite high, which increases the probability of a prosthesis infection [ 5 , 6 ]. It should not be forgotten that SBTKA has advantages such as high patient satisfaction, short general rehabilitation period and low cost.…”