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Health-related quality of life after open-wedge high tibial osteotomy

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

(1) To monitor longitudinal changes in health-related quality of life (HRQOL), pain, knee function, and return to work (RtW) following high tibial osteotomy (HTO) for medial compartment osteoarthritis (OA), and (2) to investigate the influences of psychopathological comorbidities on preoperative impairment and post-operative course.

Methods

Sixty-four patients were prospectively followed for 24 months after HTO to determine HRQOL, pain, functional outcome, and RtW. Psychopathological comorbidities (e.g. depression) were determined preoperatively. Patients with no psychological distress (ND) were compared to patients with psychological distress (PD) in order to investigate the influence of psychopathological comorbidities on outcome.

Results

There was a significant increase in HRQOL and decrease in pain from 6 month follow-up on. Functional outcomes increased significantly from 12 month follow-up on. In general, there was a steady state of outcomes from 6- to 12-month follow-up on. At final follow-up, 90 % returned to their previous occupation without limitations. Mental component summary (MCS) and functional outcome showed a positive correlation with RtW, while depression had a negative one. A significantly inferior outcome of group PD versus ND was observed at baseline and early follow-up. RtW was significantly prolonged in group PD (8.9 ± 7.6 vs. 3.9 ± 3 months; p < 0.001). At final follow-up, both groups presented with comparable outcomes.

Conclusion

HTO for medial compartment OA significantly improves HRQOL, pain, and knee function. Time to RtW is high and critically depends on PD. Further, extend of preoperative impairments, an initially inferior course, and inferior MCS outcome was influenced by PD. However, otherwise no significant differences were observed between groups PD and ND at final follow-up.

Level of evidence

Prospective case series, II.

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Acknowledgments

The authors would like to thank E. Bartsch for data acquisition, and Prof. Dr. P. Herschbach, Munich, and Prof. Dr. K. Köhle, Cologne, for advice on HRQOL and the psychosomatic aspects of this study.

Authors’ contributions

Tim Saier designed the study, analysed the data, and drafted the abstract, introduction, material and methods, results, and discussion; Philipp Minzlaff designed the study, analysed the data, and drafted the abstract, introduction, results, and discussion; Matthias J. Feucht designed the study and critically reviewed introduction, results, and discussion; Lena Lämmle analysed the statistics and drafted the materials and methods, results, and tables; Maike Burghoff collected and analysed the data, and processed the figures; Christoph Ihle discussed the results; Andreas B Imhoff critically reviewed the study; and Stefan Hinterwimmer designed and critically reviewed the study.

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    Authors and Affiliations

    1. Department of Orthopedic Sports Medicine, Klinikum rechts der Isar, Technische Universtität München, 81679, Munich, Germany

      Tim Saier, Philipp Minzlaff, Maike Burghoff, Andreas B. Imhoff & Stefan Hinterwimmer

    2. Department of Traumatology and Reconstructive Joint Surgery, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau am Staffelsee, Germany

      Tim Saier

    3. Chirurgische Klinik Dr. Rinecker, Munich, Germany

      Philipp Minzlaff

    4. Department Orthopedics and Traumatology, University of Freiburg, Freiburg, Germany

      Matthias J. Feucht

    5. MSH Medical School Hamburg, Hamburg, Germany

      Lena Lämmle

    6. Department of Traumatology and Reconstructive Surgery, BG Traumacenter Tübingen, University of Tübingen, Tübingen, Germany

      Christoph Ihle

    7. OrthoPlus Germany, Munich, Germany

      Stefan Hinterwimmer

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    Correspondence to Andreas B. Imhoff.

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    Tim Saier and Philipp Minzlaff have contributed equally to this work.

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    Saier, T., Minzlaff, P., Feucht, M.J. et al. Health-related quality of life after open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 25, 934–942 (2017). https://doi.org/10.1007/s00167-015-3938-4

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