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A predictive score of high tibial osteotomy survivorship to help in surgical decision-making: the SKOOP score

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The high tibial osteotomy (HTO) survival rate is strongly correlated with surgical indications and predictive factors. This study aims to assess HTO survival in the long term, to determine the main predictive factors of this survival, to propose a predictive score for HTO based on those factors.

Methods

This multicentric study included 481 HTO between 2004 and 2015. The inclusion criteria were all primary HTO in patients 70 years old and younger, without previous anterior cruciate ligament injury, and without the limitation of body mass index (BMI). The assessed data were preoperative clinical and radiological parameters, the surgical technique, the complications, the HKA (hip knee ankle angle) correction postoperatively, and the surgical revision at the last follow-up.

Results

The mean follow-up was 7.8 ± 2.9 years. The HTO survival was 93.1% at 5 years and 74.1% at 10 years. Age < 55, female sex, BMI < 25 kg/m2 and incomplete narrowing were preoperative factors that positively impacted HTO survival. A postoperative HKA angle greater than 180° was a positive factor for HTO survival. The SKOOP (Sfa Knee OsteOtomy Predictive) score, including age (threshold value of 55 years), BMI (threshold values of 25 and 35 kg/m2), and the presence or absence of complete joint line narrowing, have been described. If the scale was greater than 3, the survival probability was significantly lower (p < 0.001) than if the scale was less than 3.

Conclusion

A predictive score including age, BMI, and the presence or absence of joint line narrowing can be a helpful in making decisions about HTO, particularly in borderline cases.

Level of evidence

Retrospective cohort study. Level III.

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Abbreviations

ACL:

Anterior cruciate ligament

BMI:

Body mass index

HKA:

Hip knee ankle

HTO:

High tibial osteotomy

mMDFA:

Mechanical medial distal femoral angle

MPTA:

Medial proximal tibial angle

ROM:

Range of motion

SKOOP score:

Sfa Knee OsteOtomy Predictive score

TKA:

Total knee arthroplasty

UKA:

Unicompartmental knee arthroplasty

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Acknowledgements

NR.

Funding

This study was funded by the Francophone Arthroscopy Society (SFA).

Author information

Authors and Affiliations

  1. Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Lyon University Hospital, Lyon, France

    Cécile Batailler

  2. IFSTTAR, Univ Lyon, Claude Bernard Lyon 1 University, LBMC UMR_T9406, F69622, Lyon, France

    Cécile Batailler

  3. Clinique Mutualiste de La Porte de L’Orient, 3, Rue Robert de La Croix, 56100, Lorient, France

    Thomas Gicquel

  4. Clinique du Sport de Bordeaux-Mérignac, 2, Rue Georges-Nègrevergne, 33700, Mérignac, France

    Nicolas Bouguennec

  5. Service de Chirurgie Orthopédique, Hôpital Mignot, 177, Rue de Versailles, 78150, Le Chesnay, France

    Camille Steltzlen

  6. Centre Ostéo-Articulaire Des Cèdres, Clinique Des Cèdres, 5, Rue Des Tropiques, 38130, Echirolles, France

    Nicolas Tardy

  7. Clinique Des Alpes Du Sud, 3, Rue Antonin Coronat, 05000, Gap, France

    Jean-Loup Cartier

  8. Service de Chirurgie Orthopédique, CHU Amiens-Picardie Site Sud, 1, Rond-Point du Professeur Christian-Cabrol, 80054, Amiens Cedex 1, France

    Patrice Mertl

  9. Service de Chirurgie de L’Arthrose Et du Sport, Urgences Traumatiques Des Membres, Hôpital Sud - CHU de Grenoble, Laboratoire TIMC-GMCAO UMR 5525 UGA/CNRS, 38000, Grenoble, France

    Régis Pailhé

  10. Département de Chirurgie Orthopédique et Traumatologique, Unité Inserm COMETE, UMR U1075, CHU de Caen, avenue de la Côte de Nacre, 14033, Caen, France

    Goulven Rochcongar

  11. Centre Orthopédique Santy-Hopital Privé Jean Mermoz-Ramsay Générale de Santé, 69008, Lyon, France

    Jean Marie Fayard

Authors
  1. Cécile Batailler
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  2. Thomas Gicquel
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Consortia

Francophone Arthroscopy Society

Corresponding author

Correspondence to Cécile Batailler.

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Conflict of interest

Research support from Lepine. Consultant SBM, Medacta, Zimmer Biomet, Smith & Nephew, Amplitude, Corin, Acelity, NewClip Technics and Arthrex. Speaker for Serf. Royalties from X Nov and NewClip Technics.

Ethical approval

All the procedures were performed in accordance with the ethical standards of the institutional and/or national research committee, the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the IDRCP review board under IRB n°2018-A-01353–52.

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All the patient participants provided informed consent for review of their medical records.

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Batailler, C., Gicquel, T., Bouguennec, N. et al. A predictive score of high tibial osteotomy survivorship to help in surgical decision-making: the SKOOP score. Arch Orthop Trauma Surg 143, 4843–4851 (2023). https://doi.org/10.1007/s00402-022-04694-w

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