2025 ISAKOS Biennial Congress ePoster
Short-Term Clinical Outcomes Of Medial Open-Wedge Distal Tuberosity Tibial Osteotomy For Early Osteoarthritis Of The Knee
Yoshitaka Nakao, MD, Nishinomiya, Hyogo JAPAN
Hiroshi Nakayama, MD., PhD., Nishinomiya, Hyogo JAPAN
Tomoya Iseki, MD, PhD, Nishinomiya, Hyogo JAPAN
Ryo Kanto, MD, PhD., Nishinomiya, Hyogo JAPAN
Shintaro Onishi, MD, PhD, Nishinomiya, Hyogo JAPAN
Takuya Iseki, MD, PhD, Nishimomiya, Hyogo JAPAN
Toshiya Tachibana, MD, PhD, Nishinomiya, Hyogo JAPAN
Hyogo Medical University, Nishinomiya, Hyogo, JAPAN
FDA Status Not Applicable
Summary
Although observed over a short period, DTO showed good clinical results for early-stage knee OA.
ePosters will be available shortly before Congress
Abstract
Introduction
Osteotomy around the knee is a commonly employed treatment for active patients with knee osteoarthritis (OA), and favorable outcomes have been reported. Several studies have examined the factors that influence the clinical outcomes of osteotomies. Among them, the severity of preoperative osteoarthritis is a factor that may affect postoperative clinical outcomes. However, the effect of preoperative osteoarthritic severity on the surgical outcomes has not been clarified. Although some studies have reported clinical results after Medial Open-Wedge Distal Tuberosity Tibial Osteotomy (DTO), clinical outcomes of DTO for mild osteoarthritis of the knee has yet to be investigated. The purpose of this study was to investigate the short-term clinical outcome of DTO for early knee OA.
Methods
Patients with early knee OA (Kellgren-Lawrence [K-L] grade 0 or 1) who underwent DTO at our hospital during the study period of August 2018 to April 2022 were included in the study. Subjects were periodically followed up after surgery, and pre- and postoperative radiological and clinical data at 2 years after surgery were retrospectively reviewed for each of the knees. Those without a minimum of 2 years of complete follow-up data were excluded. Clinical results were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the International Knee Documentation Committee (IKDC) subjective score preoperatively and at 2 years after surgery. As for the radiological parameters for align- ment and bone/joint geometry, the following angles were measured on a long-leg weight-bearing radiograph using dedicated software (mediCAD): hip knee ankle angle(HKAA),mechanical medial proximal tibial angle (mMPTA), % mechanical axis(%MA).
Results
The study population consisted of 26 patients (20 males and 6 females) who underwent DTO during the study period, for a total of 30 knees. The average patient age was 53.7±4.8 years (range: 44 years to 63 years). Preoperatively, the mean KOOS-5 and IKDC subjective scores were 64.4±18.5 and 57.4±20.7, respectively. Two-years post-surgery, these scores increased to 91.1±9.0 for the KOOS and 84.9±10.8 for the IKDC subjective scores, showing significant postoperative improvement in both PROMs. Preoperatively, the mean HKAA was 4.1±2.8° (varus), the mean mMPTA was 84.2±1.8°, and the mean %MA was 30.2±10.9°. At 2 years after surgery, the mean HKAA was 2.0±1.0° (valgus), the mean mMPTA was 90.2±1.9°,and the mean %MA was 58.4±4.6°
Discussion
Although observed over a short period, DTO showed good clinical results for early-stage knee OA. It was suggested that performing osteotomy at an early stage may result in a better clinical score with a relatively small amount of correction.