Standing Steadiness and Asymmetry after High Tibial Osteotomy Surgery: A 2 Year Follow-Up Study

Abstract

(1) Background: Knee osteoarthritis (OA) is a serious orthopedic problem. In this context, the high tibial osteotomy (HTO) is an established surgical procedure to reduce the load and degeneration of the affected compartment. The aim of this investigation was to judge standing steadiness and asymmetry, pain intensity and quality of life among patients who underwent HTO surgery. (2) Methods: Twenty-five male patients with medial tibiofemoral OA finished this 2 year follow-up study. Standing balance was captured using force plates with four uniaxial sensors before, 6 weeks after, 1 year after, and 2 years after HTO surgery. The percentage weight (PW) under the foot at one side, the stability (ST) index and the weight distribution (WD) index were the main outcomes. Comparisons were conducted using repeated measures analyses of variance. (3) Results: Over time, the PW under the foot at the HTO side increased on average (p < 0.001). In terms of standing steadiness, the average ST remained similar over the time points (p = 0.71). The WD index was affected by time (p = 0.003). (4) Conclusions: In order to judge short-term effects, the PW is recommended, whereas long-term effects can be identified either through the PW or the WD index.

Instrumental Gait Analysis and Tibial Plateau Modelling to Support Pre- and Post-Operative Evaluations in Personalized High Tibial Osteotomy

“…One of the major claims of opening-wedge HTO is a lateral transfer of loads for a relevant decompression of the medial compartment of the varus knee, which allows for improved mediolateral weight distribution at the tibial plateau and a more steady and symmetrical overall posture [12][13][14]. This is usually shown by reporting the time-history of the ab/adduction moment of the knee from traditional gait analysis [1, 28,33].…”

“…During surgery, an inclined osteotomy is performed at the proximal tibia, and an open wedge is created and then stabilized with an osteosynthesis plate. After surgery, the normal alignment is usually restored, which should result in the mechanical axis passing much closer to the knee joint centre, both in standing posture and during locomotion, thus also restoring physiological joint moments and load distribution on the tibial plateau [12][13][14].…”