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

  • Annette W-Dahl
  • Sören Toksvig-Larsen
  • Anders Lindstrand



The purpose was to describe physical activity with respect to leisure and working activity in patients operated on by high tibial osteotomy using the hemicallotasis technique for knee osteoarthritis (OA), preoperatively and 10 years postoperatively.


Seventy-nine patients, median age 55 (range 35–66), operated on by high tibial osteotomy using the hemicallotasis technique for knee OA 2001–2003 were included. Questionnaires for evaluation of physical and working activity, satisfaction as well as the Knee injury and Osteoarthritis Outcome Score (KOOS) were filled in preoperatively and 2 and 10 years postoperatively. Conversion to knee arthroplasty was obtained through the Swedish Knee Arthroplasty Register. Changes between two postoperative measurements were assessed by Wilcoxon’s rank test.


Twenty-five patients were converted to a total knee arthroplasty, and nine patients were lost to follow-up during the 10 years, resulted in 45 patients available for follow-up. Preoperatively, 33/45 patients were physically active mainly in heavy yard/household work, and 43/45 patients were working active. Ten years after the HCO, 23/45 patients were still active with golf, dancing, hiking, etc., and 23/45 were retired. At 10 years postoperatively compared to 2 years postoperatively, the patients experienced more problems with pain (89 compared to 69, p = <0.0001). Of 45 patients, 36 were satisfied with the high tibial osteotomy surgery in general 10 years postoperatively, while 13/45 were satisfied with their sport and recreational function.


The 10-year results indicate that high tibial osteotomy using the hemicallotasis technique for knee OA is an option for selected patients that improves the level of physical activity, with mild deterioration over time, and gives the majority of the patients the possibility to be working active until retirement.

Level of evidence

Level IV.


High tibial osteotomy Knee osteoarthritis Physical activity Working activity Satisfaction 



This study was partly founded by the Swedish National Centre for Research in Sports.


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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2015

Authors and Affiliations

  • Annette W-Dahl
    • 1
    • 2
  • Sören Toksvig-Larsen
    • 1
    • 3
  • Anders Lindstrand
    • 1
  1. 1.Department of Clinical Sciences, Lund, OrthopedicsLund UniversityLundSweden
  2. 2.Department of OrthopedicsSkane University Hospital LundLundSweden
  3. 3.Department of OrthopedicsHässleholm HospitalHässleholmSweden

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