Survivorship of high tibial osteotomy in the treatment of osteoarthritis of the knee

Abstract

Previous studies from single centres or single-surgeon series report good early and midterm results for high tibial osteotomy (HTO) in the treatment of osteoarthritis of the knee. However, the survivorship of HTO at a national level is unknown. This registry-based study included 3195 high HTOs performed between 1987 and 2008. Kaplan-Meier analysis revealed an overall survivorship of 89% (95% confidence interval (CI) 88 to 90) at five years and 73% (95% CI 72 to 75) at ten years, when conversion to total knee replacement was taken as the endpoint. Females and patients aged > 50 years had worse survivorship than males or patients aged ≤ 50 years (hazard ratio (HR) 1.26 (95% CI 1.11 to 1.43) and HR 1.41 (95% CI 1.23 to 1.64), respectively). The survivorship of HTOs performed between 1998 to 2008 was worse than for those performed between 1987 and 1997.

Ten-year results of physical activity after high tibial osteotomy in patients with knee osteoarthritis

“…The present study is a single-centre study resulting in relatively few patients left to evaluate after 10 years. One-third of the patients included in our study had been converted to knee arthroplasty within 10 years and that is in line with the findings in earlier published population-based studies from Sweden [25] and Finland [10], showing that the 10-year risk of revision was approximately 30 %. However, there are some publications including at least 100 patients, showing rates of revision at 10 years between 5 and 20 % [4-6, 12, 22].…”

Opening-Wedge High Tibial Osteotomy: Review of 100 Consecutive Cases

“…This survivorship number is consistent with numbers reported by other authors. [47][48][49][50][51][52] As expected, the need for arthroplasty was associated with longer follow-up periods. 37 Surprisingly, osteotomy fixation with a smaller plate with only 4 screws was associated with increased postoperative pain even after correction for follow-up length (the senior author predominantly used the smaller plate early in the study).…”

High Tibial Osteotomy in Combination With Chondrogenesis After Stem Cell Therapy: A Histologic Report of 8 Cases

“…Longterm results theoretically should not be worse than currently published results of standard HTO cases, whereby it has been reported that the survivorship of osteotomy ranges from 75% to 95% up to 5 years and from 51% to 98% at 10 years. [53][54][55][56][57][58][59][60][61] The trial design for a phase II randomized controlled trial using the described technique has just been approved by the US Food and Drug Administration involving the institutions of the first and second authors (K-Y.S. and A.A.), the first author being the principal investigator.…”