Abstract
Purpose
This study was to evaluate the survivorship of HTO for the treatment of medial compartment osteoarthritis (OA) in young and active patients from two teaching hospitals in a single city.
Methods
This is a retrospective cohort multicenter study looking at HTO for treatment of medial compartment OA. We analyzed a case series of HTO’s performed by four surgeons in two centres over a 14-year period. Failure was defined as conversion to total knee replacement (TKR). All cases where additional procedures for instability of the knee were performed at the time of the index surgery were excluded. Time to failure was recorded, and a Kaplan-Meir (KM) analysis was performed to evaluate survivorship. Univariate binary regression analysis was undertaken to identify associations between risk factors and failure.
Results
A total of 96 patients were included in the study with a median age was 45 years. The survivorship at five years post-op was 90.3%, and at ten years post-op, it was 82%. Patients that were 14 years after surgery had a survivorship of 65%. Also, 18.8% of patients required the removal of their metalwork. The overall complication rate was 6.3%. The univariate regression analysis showed that higher age (p = 0.02) and larger corrections requiring the use of bone graft increased the risk of failure (p = 0.02). There was no statistically significant correlation between laterality, gender, complication rate, and pre-operative alignment to survivorship.
Conclusion
This is one of the largest reported case series of HTO’s with comparable survivorship at five and ten year follow-up compared to the reported literature. There was an association found between increasing age and larger corrections requiring bone graft at index procedure to increasing failure rate.
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Data availability
The datasets generated during and/or analyzed during the current study are not publicly available.
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Contributions
Mr. Rahul Bhattacharyya: primary author, written and edited manuscript, study plan, data analysis.
Mr. Almothenna Alloush: co-author data collection, data analysis, first draft and writing manuscript.
Miss Christina Wilson: data collection, data analysis.
Dr. James Doonan: co-author, data analysis, statistical analysis, editing.
Mr. Brian Rooney: co-author, performed the operations, editing manuscript.
Mr. Colin Walker: co-author, performed the operations, editing manuscript.
Mr. Angus Maclean: co-author, performed the operations, editing manuscript.
Mr. Mark Blyth: senior author, designed the study, performed the operations, editing manuscript.
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This study was registered and approved by the local Caldicott Guardian. It was registered in the research registry with an ID number 8003.
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Bhattacharyya, R., Alloush, A., Wilson, C. et al. Survivorship of high tibial osteotomy in the treatment of osteoarthritis of the knee: a retrospective cohort study with fourteen years’ follow-up. International Orthopaedics (SICOT) 47, 1765–1770 (2023). https://doi.org/10.1007/s00264-023-05802-0
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DOI: https://doi.org/10.1007/s00264-023-05802-0