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Long-term results and comparison of the three different high tibial osteotomy and fixation techniques in medial compartment arthrosis

BACKGROUND: The purpose of this study is to report and analyze the long-term outcomes of the patients who underwent high tibial osteotomy (HTO) with three different techniques for the treatment of medial compartment arthrosis. METHODS: A total of 187 patients (195 knees) who underwent HTO between 19...

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Autores principales: Polat, Gökhan, Balcı, Halil İbrahim, Çakmak, Mehmet Fevzi, Demirel, Mehmet, Şen, Cengiz, Aşık, Mehmet
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5356246/
https://www.ncbi.nlm.nih.gov/pubmed/28302132
http://dx.doi.org/10.1186/s13018-017-0547-6
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author Polat, Gökhan
Balcı, Halil İbrahim
Çakmak, Mehmet Fevzi
Demirel, Mehmet
Şen, Cengiz
Aşık, Mehmet
author_facet Polat, Gökhan
Balcı, Halil İbrahim
Çakmak, Mehmet Fevzi
Demirel, Mehmet
Şen, Cengiz
Aşık, Mehmet
author_sort Polat, Gökhan
collection PubMed
description BACKGROUND: The purpose of this study is to report and analyze the long-term outcomes of the patients who underwent high tibial osteotomy (HTO) with three different techniques for the treatment of medial compartment arthrosis. METHODS: A total of 187 patients (195 knees) who underwent HTO between 1990 and 2010 were retrospectively evaluated. Eighty-eight knees, opening-wedge osteotomy with Puddu plate (group A); 51 knees, transverse osteotomy below the tubercle with external fixator (group B); and 29 knees, closing-wedge osteotomy with staple fixation (group C) were included in the study. The patients (mean age 44.9 ± 10.6 years, mean follow-up of 12.4 ± 3.2 years) were called for final controls and survival rates of the knees, and functional evaluations of the patients were performed using Knee Society Score (KSS) and Hospital for Special Surgery (HSS) knee score assessments. RESULTS: In the comparison of the three groups, there were no differences regarding the mean age, preoperative arthrosis levels, or preoperative deformity analyses (n.s.). The main finding of these comparisons showed that the closing-wedge osteotomy has the greatest lateralization effect on mechanical axis deviation (MAD) (p = 0.024), the greatest valgization effect on medial proximal tibial angles (MPTA) (p = 0.026), and the lowest posterior tibial slope (PTS) angles (p = 0.032) in comparison to the other groups. There were no functional differences between the three groups in the long-term assessment of patients with KSS and HSS knee scores. According to the Kaplan–Meier survival analysis, the probability of the survival of the native knee joint after HTO was 93.4% in 5 years and 71.2% in 10 years in our study group. During the follow-up of the 168 knees, revision surgery with total knee replacement was needed in 27 knees (16%). The mean time from HTO to total knee replacement was 8.9 years in these patients. CONCLUSIONS: HTO has acceptable long-term clinical and functional results that should not be underestimated by orthopedic surgeons under pressure to perform arthroplasty operations.
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spelling pubmed-53562462017-03-22 Long-term results and comparison of the three different high tibial osteotomy and fixation techniques in medial compartment arthrosis Polat, Gökhan Balcı, Halil İbrahim Çakmak, Mehmet Fevzi Demirel, Mehmet Şen, Cengiz Aşık, Mehmet J Orthop Surg Res Research Article BACKGROUND: The purpose of this study is to report and analyze the long-term outcomes of the patients who underwent high tibial osteotomy (HTO) with three different techniques for the treatment of medial compartment arthrosis. METHODS: A total of 187 patients (195 knees) who underwent HTO between 1990 and 2010 were retrospectively evaluated. Eighty-eight knees, opening-wedge osteotomy with Puddu plate (group A); 51 knees, transverse osteotomy below the tubercle with external fixator (group B); and 29 knees, closing-wedge osteotomy with staple fixation (group C) were included in the study. The patients (mean age 44.9 ± 10.6 years, mean follow-up of 12.4 ± 3.2 years) were called for final controls and survival rates of the knees, and functional evaluations of the patients were performed using Knee Society Score (KSS) and Hospital for Special Surgery (HSS) knee score assessments. RESULTS: In the comparison of the three groups, there were no differences regarding the mean age, preoperative arthrosis levels, or preoperative deformity analyses (n.s.). The main finding of these comparisons showed that the closing-wedge osteotomy has the greatest lateralization effect on mechanical axis deviation (MAD) (p = 0.024), the greatest valgization effect on medial proximal tibial angles (MPTA) (p = 0.026), and the lowest posterior tibial slope (PTS) angles (p = 0.032) in comparison to the other groups. There were no functional differences between the three groups in the long-term assessment of patients with KSS and HSS knee scores. According to the Kaplan–Meier survival analysis, the probability of the survival of the native knee joint after HTO was 93.4% in 5 years and 71.2% in 10 years in our study group. During the follow-up of the 168 knees, revision surgery with total knee replacement was needed in 27 knees (16%). The mean time from HTO to total knee replacement was 8.9 years in these patients. CONCLUSIONS: HTO has acceptable long-term clinical and functional results that should not be underestimated by orthopedic surgeons under pressure to perform arthroplasty operations. BioMed Central 2017-03-16 /pmc/articles/PMC5356246/ /pubmed/28302132 http://dx.doi.org/10.1186/s13018-017-0547-6 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Polat, Gökhan
Balcı, Halil İbrahim
Çakmak, Mehmet Fevzi
Demirel, Mehmet
Şen, Cengiz
Aşık, Mehmet
Long-term results and comparison of the three different high tibial osteotomy and fixation techniques in medial compartment arthrosis
title Long-term results and comparison of the three different high tibial osteotomy and fixation techniques in medial compartment arthrosis
title_full Long-term results and comparison of the three different high tibial osteotomy and fixation techniques in medial compartment arthrosis
title_fullStr Long-term results and comparison of the three different high tibial osteotomy and fixation techniques in medial compartment arthrosis
title_full_unstemmed Long-term results and comparison of the three different high tibial osteotomy and fixation techniques in medial compartment arthrosis
title_short Long-term results and comparison of the three different high tibial osteotomy and fixation techniques in medial compartment arthrosis
title_sort long-term results and comparison of the three different high tibial osteotomy and fixation techniques in medial compartment arthrosis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5356246/
https://www.ncbi.nlm.nih.gov/pubmed/28302132
http://dx.doi.org/10.1186/s13018-017-0547-6
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