Short-Term Results of Hybrid Closed-Wedge High Tibial Osteotomy: A Case Series with a Minimum 3-Year Follow-up
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Purpose: High tibial valgus osteotomy (HTO) is a wellestablished surgical procedure for patients with medial compartment osteoarthritis (OA) of the knee. The hybrid closedwedge HTO (CWHTO) procedure permits extensive correction in patients with severe deformities or patellofemoral joint OA. The aim of this study was to report the shortterm results in a consecutive series of patients treated with hybrid CWHTO.Materials and Methods: We retrospectively evaluated the clinical outcomes and radiographic parameters in 29 consecutive knees that underwent hybrid CWTHO to correct medial compartment OA at an average followup of 52.6 months. Clinical outcomes were assessed using the Lysholm score and knee scoring system of the Japanese Orthopedic Association (JOA). The KellgrenLawrence grading system and pre and postoperative mechanical axis (MA), femorotibial angle (FTA), posterior tibial slope, and patella height were assessed.Results: The FTA and MA significantly changed from 180.7° to 170.4° and from 22.0° to 60.2°, respectively. No significant differences were observed between the mean pre and postoperative posterior tibial slope, InsallSalvati ratio, or CatonDeschamps index. The postoperative JOA and Lysholm scores significantly improved from 76.7 to 95.8 and from 58.8 to 90.2, respectively. Conclusions: Satisfactory outcomes can be achieved with hybrid CWHTO in patients with medial OA.
Abstract
Purpose: High tibial valgus osteotomy (HTO) is a wellestablished surgical procedure for patients with medial compartment osteoarthritis (OA) of the knee. The hybrid closedwedge HTO (CWHTO) procedure permits extensive correction in patients with severe deformities or patellofemoral joint OA. The aim of this study was to report the shortterm results in a consecutive series of patients treated with hybrid CWHTO.Materials and Methods: We retrospectively evaluated the clinical outcomes and radiographic parameters in 29 consecutive knees that underwent hybrid CWTHO to correct medial compartment OA at an average followup of 52.6 months. Clinical outcomes were assessed using the Lysholm score and knee scoring system of the Japanese Orthopedic Association (JOA). The KellgrenLawrence grading system and pre and postoperative mechanical axis (MA), femorotibial angle (FTA), posterior tibial slope, and patella height were assessed.Results: The FTA and MA significantly changed from 180.7° to 170.4° and from 22.0° to 60.2°, respectively. No significant differences were observed between the mean pre and postoperative posterior tibial slope, InsallSalvati ratio, or CatonDeschamps index. The postoperative JOA and Lysholm scores significantly improved from 76.7 to 95.8 and from 58.8 to 90.2, respectively. Conclusions: Satisfactory outcomes can be achieved with hybrid CWHTO in patients with medial OA.
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