Focal cartilage defects of the lateral compartment do influence the outcome after high tibial valgus osteotomy

Introduction: High tibial medial open-wedge valgus osteotomy (HTO) is a well-established procedure for unicompartimental medial osteoarthritis of the young and active patient. However, the influence of cartilage defects of the lateral compartment on the total outcome remains obscure. Methods: From 2...

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Main Authors: Heinz Tizian, Reppenhagen Stephan, Wagenbrenner Mike, Horas Konstantin, Ohlmeier Malte, Schäfer Thomas, Rudert Maximilian, Barthel Thomas, Weißenberger Manuel
Format: Article
Language:English
Published: EDP Sciences 2021-01-01
Series:SICOT-J
Subjects:
Online Access:https://www.sicot-j.org/articles/sicotj/full_html/2021/01/sicotj210062/sicotj210062.html
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author Heinz Tizian
Reppenhagen Stephan
Wagenbrenner Mike
Horas Konstantin
Ohlmeier Malte
Schäfer Thomas
Rudert Maximilian
Barthel Thomas
Weißenberger Manuel
author_facet Heinz Tizian
Reppenhagen Stephan
Wagenbrenner Mike
Horas Konstantin
Ohlmeier Malte
Schäfer Thomas
Rudert Maximilian
Barthel Thomas
Weißenberger Manuel
author_sort Heinz Tizian
collection DOAJ
description Introduction: High tibial medial open-wedge valgus osteotomy (HTO) is a well-established procedure for unicompartimental medial osteoarthritis of the young and active patient. However, the influence of cartilage defects of the lateral compartment on the total outcome remains obscure. Methods: From 2005 to 2012, a total of 63 patients underwent HTO for medial osteoarthritis of the knee at a single university orthopaedic center. Baseline data as well as intraoperative findings, including the grade and location of cartilage lesions, were evaluated retrospectively. Two groups were formed regarding the integrity of the lateral tibiofemoral compartment as measured by the Outerbridge score (group A: no lateral cartilage defects, group B: mild to moderate lateral cartilage defects). Functional outcome was assessed using the Knee and Osteoarthritis Outcome Score (KOOS), including its five subscores. Results: Comparing pre- and postoperative data, we identified an overall benefit of the HTO procedure as measured by the KOOS. Group A (no lateral cartilage defects) showed an increase in all five KOOS subscores (p = 0.00–0.01), whereas for group B (mild to moderate lateral cartilage defects), only two KOOS subscores revealed a significant increase (p = 0.03–0.04). There was also a statistically significant difference in the total KOOS score with higher values for group A at the postoperative visit. Cartilage defects with a higher Outerbridge score were associated with lower postoperative KOOS subscores. Discussion: Mild to moderate cartilage defects of the lateral compartment humble the total outcome after HTO procedure. Thus, indication for HTO should be made very carefully if any degree of lateral cartilage degeneration is present.
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spelling doaj.art-6b906865fcd94dadae0704c128e63e662022-12-21T21:48:06ZengEDP SciencesSICOT-J2426-88872021-01-0174410.1051/sicotj/2021044sicotj210062Focal cartilage defects of the lateral compartment do influence the outcome after high tibial valgus osteotomyHeinz Tizian0Reppenhagen Stephan1Wagenbrenner Mike2Horas Konstantin3Ohlmeier Malte4Schäfer Thomas5Rudert Maximilian6Barthel Thomas7Weißenberger Manuel8Department of Orthopaedic Surgery, University of WuerzburgDepartment of Orthopaedic Surgery, University of WuerzburgDepartment of Orthopaedic Surgery, University of WuerzburgDepartment of Orthopaedic Surgery, University of WuerzburgDepartment of Orthopaedic Surgery, HELIOS ENDO-Klinik HamburgDepartment of Orthopaedic Surgery, University of WuerzburgDepartment of Orthopaedic Surgery, University of WuerzburgDepartment of Orthopaedic Surgery, University of WuerzburgDepartment of Orthopaedic Surgery, University of WuerzburgIntroduction: High tibial medial open-wedge valgus osteotomy (HTO) is a well-established procedure for unicompartimental medial osteoarthritis of the young and active patient. However, the influence of cartilage defects of the lateral compartment on the total outcome remains obscure. Methods: From 2005 to 2012, a total of 63 patients underwent HTO for medial osteoarthritis of the knee at a single university orthopaedic center. Baseline data as well as intraoperative findings, including the grade and location of cartilage lesions, were evaluated retrospectively. Two groups were formed regarding the integrity of the lateral tibiofemoral compartment as measured by the Outerbridge score (group A: no lateral cartilage defects, group B: mild to moderate lateral cartilage defects). Functional outcome was assessed using the Knee and Osteoarthritis Outcome Score (KOOS), including its five subscores. Results: Comparing pre- and postoperative data, we identified an overall benefit of the HTO procedure as measured by the KOOS. Group A (no lateral cartilage defects) showed an increase in all five KOOS subscores (p = 0.00–0.01), whereas for group B (mild to moderate lateral cartilage defects), only two KOOS subscores revealed a significant increase (p = 0.03–0.04). There was also a statistically significant difference in the total KOOS score with higher values for group A at the postoperative visit. Cartilage defects with a higher Outerbridge score were associated with lower postoperative KOOS subscores. Discussion: Mild to moderate cartilage defects of the lateral compartment humble the total outcome after HTO procedure. Thus, indication for HTO should be made very carefully if any degree of lateral cartilage degeneration is present.https://www.sicot-j.org/articles/sicotj/full_html/2021/01/sicotj210062/sicotj210062.htmlkneemedial osteoarthritishigh tibial osteotomycartilage defect
spellingShingle Heinz Tizian
Reppenhagen Stephan
Wagenbrenner Mike
Horas Konstantin
Ohlmeier Malte
Schäfer Thomas
Rudert Maximilian
Barthel Thomas
Weißenberger Manuel
Focal cartilage defects of the lateral compartment do influence the outcome after high tibial valgus osteotomy
SICOT-J
knee
medial osteoarthritis
high tibial osteotomy
cartilage defect
title Focal cartilage defects of the lateral compartment do influence the outcome after high tibial valgus osteotomy
title_full Focal cartilage defects of the lateral compartment do influence the outcome after high tibial valgus osteotomy
title_fullStr Focal cartilage defects of the lateral compartment do influence the outcome after high tibial valgus osteotomy
title_full_unstemmed Focal cartilage defects of the lateral compartment do influence the outcome after high tibial valgus osteotomy
title_short Focal cartilage defects of the lateral compartment do influence the outcome after high tibial valgus osteotomy
title_sort focal cartilage defects of the lateral compartment do influence the outcome after high tibial valgus osteotomy
topic knee
medial osteoarthritis
high tibial osteotomy
cartilage defect
url https://www.sicot-j.org/articles/sicotj/full_html/2021/01/sicotj210062/sicotj210062.html
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