Does preoperative bone marrow edema affect clinical outcomes after medial open-wedge high tibial osteotomy?
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Purpose The aim of this study is to evaluate the results of high tibial osteotomy (HTO) in patients with bone marrow edema (BME) and assess the effect of factors on the subsequent results. Methods A total of 138 patients who underwent medial open-wedge HTO using locking plate were included in this study. BME was observed in 108 patients using preoperative magnetic resonance imaging. Clinical results were evaluated before HTO and postoperatively at 12 months. Moreover, we evaluated the factors affecting the clinical results. Results The clinical scores were all significantly improved regardless of the presence of BME. There were no differences in improvement of clinical scores between patients with BME and without BME. Patients with BME showed higher postoperative Western Ontario and McMaster Universities Arthritis Index (WOMAC) stiffness scores than patients without BME. Furthermore, patients with BME on both the femur and tibia showed lower Knee Society function scores than patients with BME on either the femur or the tibia. Patients with large BME lesions exhibited a lower Hospital for Special Surgery score and WOMAC pain scores, postoperatively. In patients with BME, patients with undercorrection showed significantly lower improvement in WOMAC pain scores compared with patients with acceptable correction. Conclusions The clinical improvement after HTO in patients with varus and medial osteoarthritis was not different regardless of the presence or absence of BME. However, accurate alignment should be considered essential for achieving better clinical outcomes in patients with preoperative BME.
Abstract
Purpose The aim of this study is to evaluate the results of high tibial osteotomy (HTO) in patients with bone marrow edema (BME) and assess the effect of factors on the subsequent results. Methods A total of 138 patients who underwent medial open-wedge HTO using locking plate were included in this study. BME was observed in 108 patients using preoperative magnetic resonance imaging. Clinical results were evaluated before HTO and postoperatively at 12 months. Moreover, we evaluated the factors affecting the clinical results. Results The clinical scores were all significantly improved regardless of the presence of BME. There were no differences in improvement of clinical scores between patients with BME and without BME. Patients with BME showed higher postoperative Western Ontario and McMaster Universities Arthritis Index (WOMAC) stiffness scores than patients without BME. Furthermore, patients with BME on both the femur and tibia showed lower Knee Society function scores than patients with BME on either the femur or the tibia. Patients with large BME lesions exhibited a lower Hospital for Special Surgery score and WOMAC pain scores, postoperatively. In patients with BME, patients with undercorrection showed significantly lower improvement in WOMAC pain scores compared with patients with acceptable correction. Conclusions The clinical improvement after HTO in patients with varus and medial osteoarthritis was not different regardless of the presence or absence of BME. However, accurate alignment should be considered essential for achieving better clinical outcomes in patients with preoperative BME.
참고문헌 (25)
- Amendola A, "Results of high tibial osteotomy : review of the literature", Int Orthop, 34, pp.155~160 (2010)
- Sprenger TR, "Tibial osteotomy for the treatment of varus gonarthrosis. Survival and failure analysis to twenty-two years", J Bone Joint Surg Am, 85, pp.469~474 (2003)
- Park SH, "Trends in knee surgery research in the official journal of the Korean knee society during the period 1999–2018 : a bibliometric review", Knee Surg Relat Res, 32, pp.28~ (2020)
- Na YG, "Change of joint-line convergence angle should be considered for accurate alignment correction in high tibial osteotomy", Knee Surg Relat Res, 33, pp.4~ (2021)
- Kang BY, "How to achieve an optimal alignment in medial opening wedge high tibial osteotomy?", Knee Surg Relat Res, 34, pp.3~ (2022)
- Fujisawa Y, "The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints", Orthop Clin North Am, 10, pp.585~608 (1979)
- Hernigou P, "Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study", J Bone Joint Surg Am, 69, pp.332~354 (1987)
- Matsushita T, "Differences in preoperative planning for high-tibial osteotomy between the standing and supine positions", Knee Surg Relat Res, 33, pp.8~ (2021)
- Jung WH, "Second-look arthroscopic assessment of cartilage regeneration after medial opening-wedge high tibial osteotomy", Arthroscopy, 30, pp.72~79 (2014)
- Niinimäki T, "Survivorship of high tibial osteotomy in the treatment of osteoarthritis of the knee : Finnish registry-based study of 3195 knees", J Bone Jt Surg, 94, pp.1517~1521 (2012)
- Schallberger A, "High tibial valgus osteotomy in unicompartmental medial osteoarthritis of the knee : a retrospective follow-up study over 13–21 years", Knee Surg Sports Traumatol Arthrosc, 19, pp.122~127 (2011)
- Yu JS, "Magnetic resonance imaging(mri)of the knee : a pattern approach for evaluating bone marrow edema", Crit Rev Diagn Imaging, 37, pp.261~303 (1996)
- Zanetti M, "Bone marrow edema pattern in osteoarthritic knees : correlation between MR imaging and histologic findings", Radiology, 215, pp.835~840 (2000)
- Hayes CW, "Mr imaging of bone marrow edema pattern : transient osteoporosis, transient bone marrow edema syndrome, or osteonecrosis", Radiographics, 13, pp.1001~1011 (1993)
- Welsch GH, "Three-dimensional magnetic resonance observation of cartilage repair tissue(mocart)score assessed with an isotropic three-dimensional true fast imaging with steady-state precession sequence at 3. 0 tesla", Invest Radiol, 44, pp.603~612 (2009)
- Kroner AH, "Influence of high tibial osteotomy on bone marrow edema in the knee", Clin Orthop Relat Res, 454, pp.155~162 (2007)
- Kim HJ, "More accurate correction can be obtained using a three-dimensional printed model in open-wedge high tibial osteotomy", Knee Surg Sports Traumatol Arthrosc, 26, pp.3452~3458 (2018)
- Felson DT, "The association of bone marrow lesions with pain in knee osteoarthritis", Ann Intern Med, 134, pp.541~549 (2001)
- Felson DT, "Bone marrow edema and its relation to progression of knee osteoarthritis", Ann Intern Med, 139, pp.330~336 (2003)
- Moore J, "Applicability of a modified angular correction measurement method for open-wedge high tibial osteotomy", Knee Surg Sports Traumatol Arthrosc, 25, pp.846~852 (2017)
- Elson DW, "High reliability in digital planning of medial opening wedge high tibial osteotomy, using miniaci’s method", Knee Surg Sports Traumatol Arthrosc, 23, pp.2041~2048 (2015)
- Jones LD, "Assessing accuracy requirements in high tibial osteotomy : a theoretical, computer-based model using ap radiographs", Knee Surg Sports Traumatol Arthrosc, 25, pp.2952~2956 (2017)
- Ivarsson I, "High tibial osteotomy for medial osteoarthritis of the knee. A 5 to 7 and 11 year follow-up", J Bone Joint Surg Br, 72, pp.238~244 (1990)
- Kim MS, "Degree of preoperative subchondral bone marrow lesion is associated with postoperative outcome after medial opening wedge high tibial osteotomy", Am J Sports Med, 47, pp.2454~2463 (2019)
- Yang HY, "The influence of preoperative tibial bone marrow edema on outcomes after medial opening-wedge high tibial osteotomy", J Bone Joint Surg Am, 102, pp.2068~2076 (2020)