FUNCTIONAL OUTCOME OF PATIENTS WITH MODERATE-TO-SEVERE MEDIAL COMPARTMENT OSTEOARTHRITIS KNEE TREATED BY HIGH TIBIAL OSTEOTOMY AT A TERTIARY CARE CENTER
DOI:
https://doi.org/10.22159/ajpcr.2023.v16i9.49769Keywords:
Knee osteoarthritis, Medial compartment, Tibial osteotomy, Functional outcome.Abstract
Objectives: (1) The aims and objectives of the study are to assess functional outcomes in knee osteoarthritis (OA) cases treated by high tibial osteotomy (HTO) and (2) to study the complications in patients undergoing HTO.
Methods: This was a prospective study conducted in the Department of Orthopedics of a tertiary care medical college. 50 patients with moderate-to-severe OA of medial compartment of knee were included in this study. All patients underwent HTO. Post-operatively, patients were followed up for 6 months. During follow-up visits, reduction in pain intensity and functional outcome were assessed by visual analog scale (VAS) score and Japanese Orthopedic Association (JOA) Score. Patients were also assessed for complications if any. For statistical purposes, p<0.05 was taken as statistically significant.
Results: Out of 50 studied cases, there was a female preponderance with an M: F ratio of 1:1.38. The mean age of affected cases was found to be 62.32±8.94 years. 11 (22.00%) patients were obese (body mass index [BMI] ≥30) and 32 (64.00%) patients were overweight (BMI ≥25 but <30). 7 (14.00%) patients had BMI <25. 38 (76%) patients had severe OA whereas in remaining 12 (24%) patients, there was moderate OA. There was a significant reduction in pain, as assessed by VAS score, at the time of final follow-up as compared to VAS score at the time of presentation (p<0.0001). Similarly, there was a significant functional improvement, as assessed by JOA score, at the time of final follow-up as compared to JOA score at the time of presentation (p<0.0001). 7 (14%) patients developed minor complications. All these complications were managed conservatively.
Conclusion: Patients with moderate to severe OA of medial compartment of knee treated by HTO show excellent outcomes in terms of pain relief and functional outcomes.
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References
Guilak F. Biomechanical factors in osteoarthritis. Best Pract Res Clin Rheumatol 2011;25:815-23. doi:10.1016/j.berh.2011.11.013
Primorac D, Molnar V, Rod E, Jeleč Ž, Čukelj F, Matišić V, et al. Knee osteoarthritis: A review of pathogenesis and state-of-the-art non-operative therapeutic considerations. Genes (Basel) 2020;11:854. doi:10.3390/genes11080854
Snoeker B, Turkiewicz A, Magnusson K, Frobell R, Yu D, Peat G, et al. Risk of knee osteoarthritis after different types of knee injuries in young adults: A population-based cohort study. Br J Sports Med 2020;54:725-30. doi:10.1136/bjsports-2019-100959
Chen D, Shen J, Zhao W, Wang T, Han L, Hamilton JL, et al. Osteoarthritis: Toward a comprehensive understanding of pathological mechanism. Bone Res 2017;5:16044. doi:10.1038/boneres.2016.44
Roemer FW, Guermazi A, Demehri S, Wirth W, Kijowski R. Imaging in osteoarthritis. Osteoarthritis Cartilage 2022;30:913-34. doi:10.1016/j. joca.2021.04.018
Bannuru RR, Natov NS, Obadan IE, Price LL, Schmid CH, McAlindon TE. Therapeutic trajectory of hyaluronic acid versus corticosteroids in the treatment of knee osteoarthritis: A systematic review and meta-analysis. Arthritis Rheum 2009;61:1704-11. doi:10.1002/art.24925
Habib MK, Khan ZA. Radiological, functional, and anatomical outcome in patients with osteoarthritic knee undergoing high tibial osteotomy. SICOT J 2019;5:12. doi:10.1051/sicotj/2019009
Okuda M, Omokawa S, Okahashi K, Akahane M, Tanaka Y. Validity and reliability of the Japanese orthopaedic association score for osteoarthritic knees. J Orthop Sci 2012;17:750-6. doi:10.1007/s00776- 012-0274-0
Srikanth VK, Fryer JL, Zhai G, Winzenberg TM, Hosmer D, Jones G. Ameta-analysis of sex differences prevalence, incidence and severity of osteoarthritis. Osteoarthritis Cartilage 2005;13:769-81. doi:10.1016/j. joca.2005.04.014
O’Connor MI. Sex differences in osteoarthritis of the hip and knee. J Am Acad Orthop Surg 2007;15:S22-5.
Laitner MH, Erickson LC, Ortman E. Understanding the impact of sex and gender in osteoarthritis: Assessing research gaps and unmet needs. JWomens Health (Larchmt) 2021;30:634-41. doi:10.1089/jwh.2020.8828
Prashansanie Hettihewa A, Gunawardena NS, Atukorala I, Hassan F, Lekamge IN, Hunter DJ. Prevalence of knee osteoarthritis in a suburban, Srilankan, adult female population: A population-based study. Int J Rheum Dis 2018;21:394-401. doi:10.1111/1756-185X.13225
Michael JW, Schlüter-Brust KU, Eysel P. The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee [published correction appears in Dtsch Arztebl Int 2010;107:294]. Dtsch Arztebl Int 2010;107:152-62. doi:10.3238/arztebl.2010.0152
Jaiswal A, Goswami K, Haldar P, Salve HR, Singh U. Prevalence of knee osteoarthritis, its determinants, and impact on the quality of life in elderly persons in rural Ballabgarh, Haryana. J Family Med Prim Care 2021;10:354-60. doi:10.4103/jfmpc.jfmpc_1477_20
Roy MK, Hossain MZ, Siddiquee AH, Alauddin M, Islam MK, Minto AK, et al. Study of relationship between age and body mass index on knee osteoarthritis in advanced aged females in a divisional city of Bangladesh. Int J Res Orthop 2021;7:705-8.
King LK, March L, Anandacoomarasamy A. Obesity and osteoarthritis. Indian J Med Res 2013;138:185-93.
Lee R, Kean WF. Obesity and knee osteoarthritis. Inflammopharmacology 2012;20:53-8. doi:10.1007/s10787-011-0118-0
Mukherjee K, Latif A, Ranjan AK, Dugar N. High tibial osteotomy- -an effective treatment option for osteo-arthritis. J Indian Med Assoc 2013;111:801-3.
Kanakamedala AC, Hurley ET, Manjunath AK, Jazrawi LM, Alaia MJ, Strauss EJ. High tibial osteotomies for the treatment of osteoarthritis of the knee. JBJS Rev 2022;10:e21.00127. doi:10.2106/JBJS.RVW.21.00127
Khakha RS, Bin Abd Razak HR, Kley K, van Heerwaarden R, Wilson AJ. Role of high tibial osteotomy in medial compartment osteoarthritis of the knee: Indications, surgical technique and outcomes. J Clin Orthop Trauma 2021;23:101618. doi:10.1016/j.jcot.2021.101618
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