Preoperative Strength Training for Patients Undergoing High Tibial Osteotomy: A Prospective Cohort Study With Historical Controls

Kean, Crystal O.; Birmingham, Trevor B.; Garland, S. Jayne; Bryant, Dianne; Giffin, J. Robert

doi:10.2519/jospt.2011.3490

Cited by 16 publications

(6 citation statements)

References 43 publications

(59 reference statements)

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“…16,49 Previous studies on patients with total knee arthroplasty, high tibial osteotomy, and following ACL reconstruction have shown that good preoperative knee function significantly influences postoperative outcomes. 22,38,41,65 However, this study cannot establish whether this program is optimal, as it was not compared to other more or less aggressive options.…”

Section: Discussionmentioning

confidence: 99%

“…36,42 Several studies have shown that quadriceps and hamstrings strength is directly related to knee function and disability. 37,41,48 In addition, hip muscle weakness may influence loading patterns in the knee that could be detrimental for patients with articular cartilage lesions. 13 Rehabilitation programs that focus on muscle strengthening in patients with knee OA have demonstrated improved pain and knee function, along with substantial strength gains.…”

Section: The Oslo Cartilage Active Rehabilitation and Education Programmentioning

confidence: 99%

“…Furthermore, studies have shown that, for other musculoskeletal injuries, good preoperative function is essential for good postoperative results. 21,38,41,65,68 Hence, teaching patients appropriate exercises to perform and using a structured exercise program to optimize preoperative knee function could also be of potential benefit for patients with full-thickness articular cartilage lesions who require a surgical repair.…”

Section: The Oslo Cartilage Active Rehabilitation and Education Programmentioning

confidence: 99%

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The Feasibility of a 3-Month Active Rehabilitation Program for Patients With Knee Full-Thickness Articular Cartilage Lesions: The Oslo Cartilage Active Rehabilitation and Education Study

Wondrasch¹,

Årøen²,

Røtterud³

et al. 2013

Journal of Orthopaedic & Sports Physical Therapy

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Study Design Case series. Objectives To evaluate the feasibility of an active rehabilitation program for patients with knee full-thickness articular cartilage lesions. Background No studies have yet evaluated the effect of active rehabilitation in patients with knee full-thickness articular cartilage lesions or compared the effects of active rehabilitation to those of surgical interventions. As an initial step, the feasibility of such a program needs to be described. Methods Forty-eight patients with a knee full-thickness articular cartilage lesion and a Lysholm score below 75 participated in a 3-month active rehabilitation program consisting of cardiovascular training, knee and hip progressive resistance training, and neuromuscular training. Feasibility was determined by monitoring adherence to the program, clinical changes in knee function, load progression, and adverse events. Patients were tested before and after completing the rehabilitation program by using patient-reported outcomes (Knee injury and Osteoarthritis Outcome Score, International Knee Documentation Committee Subjective Knee Evaluation Form 2000) and isokinetic muscle strength and hop tests. To monitor adherence, load progression, and adverse events, patients responded to an online survey and kept training diaries. Results The average adherence rate to the rehabilitation program was 83%. Four patients (9%) showed adverse events, as they could not perform the exercises due to pain and effusion. Significant and clinically meaningful improvement was found, based on changes on the International Knee Documentation Committee Subjective Knee Evaluation Form 2000, the Knee injury and Osteoarthritis Outcome Score quality of life subscale, isokinetic muscle strength, and hop performance (P<.05), with small to large effect sizes (standardized response mean, 0.3–1.22). Conclusion The combination of a high adherence rate, clinically meaningful changes, and positive load progression and the occurrence of only a few adverse events support the potential usefulness of this program for patients with knee full-thickness cartilage lesions. This study was registered with the public trial registry Clinical Trials.gov (NCT00885729). Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2013;43(5):310–324. Epub 13 March 2013. doi:10.2519/jospt.2013.4354

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Section: Discussionmentioning

confidence: 99%

Section: The Oslo Cartilage Active Rehabilitation and Education Programmentioning

confidence: 99%

Section: The Oslo Cartilage Active Rehabilitation and Education Programmentioning

confidence: 99%

See 1 more Smart Citation

The Feasibility of a 3-Month Active Rehabilitation Program for Patients With Knee Full-Thickness Articular Cartilage Lesions: The Oslo Cartilage Active Rehabilitation and Education Study

Wondrasch¹,

Årøen²,

Røtterud³

et al. 2013

Journal of Orthopaedic & Sports Physical Therapy

View full text Add to dashboard Cite

show abstract

“…This was a shortcoming of this novel method, which may have affected the postoperative results of some patients and caused other complications [ 41 ]. It might be expected that long-term incomplete weight-bearing would produce muscular atrophy, loss of proprioception, and decreased physical activity [ 42 ]. Therefore, strict surgical indications and appropriate pre- and postoperative rehabilitation plans are essential.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors for medial open-wedge high tibial osteotomy with spacer implantation in patients with medial compartmental knee osteoarthritis

Wang

Chen

et al. 2022

J Orthop Surg Res

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Background To identify medial open-wedge high tibial osteotomy (MOWHTO) prognostic factors with wedge-shaped spacer implantation (spacer-type MOWHTO) for varus medial compartment knee osteoarthritis. Methods Patients who underwent spacer-type MOWHTO between August 2018 and September 2019 were prospectively enrolled in this study. Patients were divided into effective group and invalid group based on the Western Ontario and McMasters University Osteoarthritis Index (WOMAC) score one year postoperatively. The variables assessed at baseline and one year postoperatively including age, sex, body mass index (BMI), Kellgren–Lawrence (K–L) grade, hip–knee–ankle angle (HKAA), medial proximal tibial angle (MPTA), posterior tibial slope angle (PTSA), Blackburn–Peel index (BPI), duration of symptoms, and WOMAC score were compared. Prognostic factors were analyzed using logistic regression, and the corresponding odds ratios were also calculated. Results A total of 104 patients were enrolled in the study protocol at one year postoperatively. The WOMAC score decreased from 72.39 ± 12.95 at baseline to 20.06 ± 12.96 at one year postoperatively. Univariate analysis revealed that the significant predictors of the WOMAC score were age > 70 years, BMI > 30 kg/m2, K–L grade IV, and pre-HKAA > 10° (P < 0.1 for all). Multivariable logistic regression analysis revealed that age > 70 (OR = 4.861) and K–L grade IV (OR = 6.590) were significantly associated with the higher WOMAC score at one year postoperatively. Conclusions Spacer-type MOWHTO is an effective treatment for osteoarthritis with varus deformity. The prognostic factors for spacer-type MOWHTO are age and K–L grade.

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“…This was a shortcoming of this novel method, which may have affected the postoperative results of some patients and caused other complications [39]. It might be expected that long-term incomplete weight-bearing would produce muscular atrophy, loss of proprioception, and decreased physical activity [40]. Therefore, strict surgical indications and appropriate pre-and postoperative rehabilitation plans are essential.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors for Open-Wedge High Tibial Osteotomy with Spacer Implantation in Patients with Medial Compartmental Knee Osteoarthritis

Wang

Chen

et al. 2021

Preprint

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Background: To identify the medial open-wedge high tibial osteotomy (MOWHTO) prognostic factors with wedge-shaped spacer implantation (spacer-type MOWHTO) for varus medial compartment knee osteoarthritis.Methods: Patients who underwent spacer-type MOWHTO between August 2018 and September 2019 were prospectively enrolled in this study. Patients were divided into two groups based on Western Ontario and McMasters University Osteoarthritis Index (WOMAC) scores of 40 points at 1 year postoperatively: the effective group (n=88, 84.6%), with post-WOMAC scores 40 or less, and the invalid group (n=16, 15.4%), with post-WOMAC scores more than 40. The variables assessed at baseline and 1 year postoperatively including age, sex, body mass index (BMI), Kellgren-Lawrence (K-L) grade, hip-knee-ankle angle (HKAA), medial proximal tibial angle (MPTA), posterior tibial slope angle (PTSA), Blackburn-Peel index (BPI), duration of symptoms and WOMAC score, were compared. Prognostic factors were analyzed using logistic regression, and the corresponding odds ratios were also calculated.Results: A total of 104 patients were enrolled in the study protocol at 1 year postoperatively. The WOMAC score decreased from 72.39±12.95 at baseline to 20.06±12.96 at 1 year postoperatively. The preoperative varus was corrected to a neutral position or to mild valgus. In addition, the PTSA was decreased. At the same time, the patellar height was not significantly changed postoperatively. Univariate analysis revealed that the significant predictors of the WOMAC score were age >70 years, BMI >30 kg/m², K-L grade IV, and pre-HKAA >10° (P<0.1 for all). Multivariable logistic regression analysis revealed that age>70 (OR=4.861) and K-L grade IV (OR=6.590) were significantly associated with the WOMAC score at 1 year postoperatively.Conclusion: Spacer-type MOWHTO is an effective treatment for osteoarthritis with varus deformity. The prognostic factors for spacer-type MOWHTO were age and K-L grade.Level of evidence: III

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Preoperative Strength Training for Patients Undergoing High Tibial Osteotomy: A Prospective Cohort Study With Historical Controls

Cited by 16 publications

References 43 publications

The Feasibility of a 3-Month Active Rehabilitation Program for Patients With Knee Full-Thickness Articular Cartilage Lesions: The Oslo Cartilage Active Rehabilitation and Education Study

The Feasibility of a 3-Month Active Rehabilitation Program for Patients With Knee Full-Thickness Articular Cartilage Lesions: The Oslo Cartilage Active Rehabilitation and Education Study

Prognostic factors for medial open-wedge high tibial osteotomy with spacer implantation in patients with medial compartmental knee osteoarthritis

Prognostic Factors for Open-Wedge High Tibial Osteotomy with Spacer Implantation in Patients with Medial Compartmental Knee Osteoarthritis

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