The Effect of Cartilage Lesion in the Lateral Compartment of the Knee on the Surgical Outcome of Medial Open-Wedge High Tibial Osteotomy

Moon, Hyun Soo; Choi, Chong Hyuk; Jung, Min; Park, Sang Hoon; Lee, Dae-Young; Shin, Jae Ho; Kim, S.-H.

doi:10.1055/s-0039-1697623

Cited by 15 publications

(19 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Four comparative studies and two case series were included [ 31 , 32 , 51 – 54 ]. The baseline characteristics and patient demographic details are presented in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Despite favorable outcomes following concurrent MMPRT repair during HTO, no randomized controlled studies or large-scale cohort studies have been published [ 31 , 32 ]. To clarify the treatment effects using objective numerical values, a systematic review and meta-analysis of all available case series or comparative studies on concurrent MMPRT repair during HTO is required.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of concurrent repair of medial meniscal posterior root tears during high tibial osteotomy for medial osteoarthritis during short-term follow-up: a systematic review and meta-analysis

Shin

Hyun-Jae

Jang

et al. 2021

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background Medial meniscal posterior root tears (MMPRTs) are frequently associated with medial compartment osteoarthritis, leading to loss of meniscal hoop tension. This study aimed to evaluate the efficacy of concurrent MMPRT repair during high tibial osteotomy (HTO) compared to HTO alone in patients with medial osteoarthritis and MMPRTs. Methods The MEDLINE/PubMed, EMBASE, and Cochrane Library databases were searched for studies reporting on concurrent MMPRT repair during HTO. Pre- and postoperative data were pooled to investigate the treatment effects of concurrent MMPRT repair during HTO, and compare postoperative clinical, radiological, and arthroscopic outcomes including cartilage status and healing event rates according to the arthroscopic classification of MMPRT healing (complete, partial [lax or scar tissue], or failed healing) between HTO patients with and without concurrent MMPRT repair. The random-effect model was used to pool the standardized mean differences, odds ratios (ORs), 95% confidence intervals (CIs), and event rates. Results Seven patient subgroups in six articles divided according to meniscal repair techniques were included in the final analysis. Concurrent MMPRT repair during HTO significantly improved the Lysholm score, while no intergroup differences were observed in the postoperative Lysholm and WOMAC scores, as well as radiological and arthroscopic outcomes. Those who underwent concurrent MMPRT repair showed a higher rate of complete meniscal healing (OR: 4.792, 95% CI, 1.95–11.79), with a pooled rate of complete meniscal healing of 0.327 (95% CI, 0.19–0.46). Conclusion Concurrent MMPRT repair during HTO for medial osteoarthritis with MMPRTs has little benefits on the clinical, radiological, and arthroscopic outcomes during short-term follow-up. Further accumulation of evidence is needed for long-term effects.

show abstract

“…Four comparative studies and two case series were included [ 31 , 32 , 51 – 54 ]. The baseline characteristics and patient demographic details are presented in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of concurrent repair of medial meniscal posterior root tears during high tibial osteotomy for medial osteoarthritis during short-term follow-up: a systematic review and meta-analysis

Shin

Hyun-Jae

Jang

et al. 2021

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…9 There have been some clinical studies conducted on cartilage lesions in the lateral compartment. 21,22 Niemeyer et al 22 reported that the clinical outcomes of patients with partialthickness cartilage lesions in the lateral compartment after OWHTO were not different from those of patients with completely intact cartilage in the lateral compartment. The follow-up period of their study was about 36 months.…”

Section: Discussionmentioning

confidence: 99%

“…The follow-up period of their study was about 36 months. Moon et al 21 reported that the presence of ICRS grade 2 or 3 cartilage lesions in the lateral compartment did not affect the outcomes of OWHTO after roughly 23 months of follow-up. However, these studies only evaluated outcomes according to the cartilage status of the lateral compartment.…”

Section: Discussionmentioning

confidence: 99%

Are There Harmful Effects of Preoperative Mild Lateral or Patellofemoral Degeneration on the Outcomes of Open Wedge High Tibial Osteotomy for Medial Compartmental Osteoarthritis?

Kim

Yoon

et al. 2020

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background: Early osteoarthritis of the knee joint mostly affects the medial compartment, making osteotomy a rational approach to slow the progression of the disease. However, some patients show asymptomatic mild degeneration in the lateral or patellofemoral compartment. Purpose: To evaluate the effect of asymptomatic mild lateral or patellofemoral degeneration on the outcomes of medial open wedge high tibial osteotomy (OWHTO) by assessing the outcomes according to the preoperative status of the lateral or patellofemoral degenerative changes. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 114 patients (121 knees) who underwent biplanar OWHTO with second-look arthroscopic surgery and postoperative magnetic resonance imaging (MRI) were retrospectively enrolled. Patients were categorized into 4 groups according to the Osteoarthritis Research Society International (OARSI) and MRI Osteoarthritis Knee Score (MOAKS) classification systems. The International Cartilage Repair Society (ICRS) grade was used to evaluate the preoperative and postoperative cartilage status. Clinical outcomes were assessed by the American Knee Society (AKS) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and 36-item Short Form Health Survey (SF-36). Results: No degenerative changes in the lateral and patellofemoral compartments of knees (group I) were identified in 51.2% of cases (62 knees). Asymptomatic degenerative changes only in the lateral compartment (group II: OARSI grades 1-3 and MOAKS grades 1-3) were identified in 15.7% of cases (19 knees), changes only in the patellofemoral compartment (group III: OARSI grades 1-3 and MOAKS grades 1-3) were identified in 10.7% of cases (13 knees), and changes in both the lateral and the patellofemoral compartments (group IV) were identified in 22.3% of cases (27 knees). In the medial compartment, there was no significant difference in the improvement of MOAKS and ICRS grades among all groups ( P = .813 and .985, respectively). In the lateral and patellofemoral compartments, there was no significant difference in the decline of MOAKS ( P = .649 and .421, respectively) and ICRS grades ( P = .927 and .676, respectively) among all groups. Conclusion: The presence of mild lateral or patellofemoral degenerative changes did not affect the MRI, arthroscopic, and clinical outcomes of OWHTO. However, long-term observations are necessary to draw definitive conclusions as to whether OWHTO can be indicated in such patients without harmful effects.

show abstract

“…As such, the aim was to investigate whether these patients can achieve comparable results to patients with normal lateral knee compartments and thus can be regarded as equally indicated for HTO. Some studies suggest that asymptomatic mild to moderate focal cartilage defects of the lateral compartment can be very well accepted without negatively in uencing the total bene t of the HTO procedure [34,35].…”

Section: Discussionmentioning

confidence: 99%

Focal Cartilage Defects of the Lateral Compartment do Influence the Outcome After High Tibial Valgus Osteotomy

Heinz

Reppenhagen

Horas

et al. 2020

Preprint

View full text Add to dashboard Cite

BackgroundHigh tibial medial open-wedge valgus osteotomy (HTO) is a well-established procedure for unicompartimental medial osteoarthritis of the young and active patient. The aim of this study was to evaluate the influence of asymptomatic mild to moderate cartilage lesions of the lateral tibiofemoral compartment on the clinical outcome after HTO. MethodsFrom 2005 to 2012 a total of 63 patients underwent HTO for medial osteoarthritis of the knee at a single university orthopaedic center. Baseline data as well as intraoperative findings including the grade and location of cartilage lesions were evaluated retrospectively. Two groups were formed regarding the integrity of the lateral tibiofemoral compartment as measured by the Outerbridge score (group A: no lateral cartilage defects, group B: mild to moderate lateral cartilage defects). Functional outcome was assessed using the Knee and Osteoarthritis Outcome Score (KOOS) including its five subscores. ResultsComparing pre- and postoperative data, we identified an overall benefit of the HTO procedure as measured by the KOOS. Group A (no lateral cartilage defects) showed an increase in all five KOOS subscores (p=0.00 – 0.01), whereas for group B (mild to moderate lateral cartilage defects) only two KOOS subscores revealed a significant increase (p=0.03 – 0.04). There was also a statistically significant difference of the total KOOS score with higher values for group A at the postoperative visit. Cartilage defects with a higher Outerbridge score were associated with lower postoperative KOOS subscores. ConclusionsMild to moderate cartilage defects of the lateral compartment humble the total outcome after HTO procedure. Thus, indication for HTO should be made very carefully, if any degree of lateral cartilage degeneration is present.

show abstract

The Effect of Cartilage Lesion in the Lateral Compartment of the Knee on the Surgical Outcome of Medial Open-Wedge High Tibial Osteotomy

Cited by 15 publications

References 29 publications

Effect of concurrent repair of medial meniscal posterior root tears during high tibial osteotomy for medial osteoarthritis during short-term follow-up: a systematic review and meta-analysis

Effect of concurrent repair of medial meniscal posterior root tears during high tibial osteotomy for medial osteoarthritis during short-term follow-up: a systematic review and meta-analysis

Are There Harmful Effects of Preoperative Mild Lateral or Patellofemoral Degeneration on the Outcomes of Open Wedge High Tibial Osteotomy for Medial Compartmental Osteoarthritis?

Focal Cartilage Defects of the Lateral Compartment do Influence the Outcome After High Tibial Valgus Osteotomy

Contact Info

Product

Resources

About