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Two years Comparison of Hybrid Closed Wedge High Tibial Osteotomy vs Open Wedge High Tibial Oateotomy for Medial Compartment Osteoarthritis of The Knee
Author(s):
Takeuchi R. (Japan)
,
Takeuchi R. (Japan)
Affiliations:
Ishikawa H.
,
Ishikawa H.
Affiliations:
Yamaguchi Y.
,
Yamaguchi Y.
Affiliations:
Osawa K.
Osawa K.
Affiliations:
ESSKA Academy. Takeuchi R. May 9, 2018; 209675; P11-1583
Dr. Ryohei Takeuchi
Dr. Ryohei Takeuchi
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Abstract
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Objectives: The choice of surgical treatments for medial compartment osteoarthritis (OA) of the knee are still somewhat controversial. We developed a novel surgical procedure of Hybrid closed high tibial osteotomy (HCWHTO). Two years follow-up results from cases treated using HCWHTO or open wedge high tibial osteotomy (OWHTO) were evaluated retrospectively.

Methods: Seventy-three knees of 71 patients underwent HCWHTO (mean age 63, 45 to 78) and 87 knees of 82 patients underwent OWHTO (mean age 67, 46 to 87) for the treatment of medial compartmental osteoarthritis (OA) were studied. Clinical evaluations were accessed by KOOS, OKS and radiological results were analyzed using mechanical axis deviation ratio (%MA), tibialis posterior slope angle (TPS) and Blackburn Peel ratio (BP). Second look arthroscopic findings were analyzed to evaluate cartilage repair on patella-femoral joint before and after HTO

Results: The preoperative KOOS and OKS were 93.4±23.9, 29.4±9.3 points in the HCWHTO and 99.7±23.3, 31.8±8.2 points in the OWHTO, respectively. Two years after surgery, KOOS and OKS improved to 133.4±21.9, 40.0±6.2 points in the HCWHTO and 137.8±23.8, 41.7±7.3 points in the OWHTO, respectively. There was no significant difference between HCWHTO and OWHTO. The preoperative %MA, TPS and BP were 12±17, 8.4±2.6 and 0.68±0.3 in HCWHTO, and 20±13, 8.6±3.5 and 0.73±0.3 in OWHTO, respectively. Two years after surgery, %MA, TPS and BP changed to 58±16, 3.9±3.8 and 0.75±0.3 in HCWHTO, and 64±10, 8.8±3.4 and 0.63± 0.3 in OWHTO, respectively. In second look arthroscopic findings, the aggravation ratio of patella-femoral joint cartilage after CWHTO and OWHTO were 7% and 51 %, respectively. On the other hand, improvement ratio after HCWHTO and OWHTO were 37% and 0%, respectively.

Conclusions: Hybrid closed wedge HTO was highly successfully in correcting knee malalignment in patients with medial compartmental osteoarthritis, especially accompanied with patello-femoral joint osteoarthritis.

Keywords:
Osteoarthritis of the knee, Hybrid closed wedge HTO, Open wedge HTO, Patello-femoral join
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