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Simultaneous Bilateral Opening Wedge High Tibial Osteotomy With Structural Allograft Impaction Results In Excellent Early Recovery And Pain Reduction Similar To Unilateral Osteotomy

Simultaneous Bilateral Opening Wedge High Tibial Osteotomy With Structural Allograft Impaction Results In Excellent Early Recovery And Pain Reduction Similar To Unilateral Osteotomy

Jef Neirynck, MD, BELGIUM Nathalie Van Beek, PhD, BELGIUM Toon Claes, MD, BELGIUM Steven Claes, MD, PhD, BELGIUM Stijn Bartholomeeusen, MD, BELGIUM

AZ Herentals, Herentals, België, BELGIUM


2021 Congress   ePoster Presentation     Not yet rated

 

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Sports Medicine

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Summary: Simultaneous bilateral HTO surgery generates similar clinical outcomes compared to unilateral HTO surgery with the advantage of a single operation in the treatment of bilateral medial osteoarthritis.


Background

Patients suffering bilateral combined medial osteoarthritis (OA) and varus alignment of the knee are eligible for bilateral high tibial osteotomy (HTO) in two-staged surgery. The impact of bilateral HTO surgery on rehabilitation and early outcomes are not yet reported in current literature, even though these features are decisive to establish whether a patient is preferably treated in one or two stages.

Methods

total of 29 patients are followed after simultaneous bilateral HTO surgery. NRS, KOOS-PS and Lysholm scores are recorded at 3, 6 and 12 months. Results are compared with outcomes of unilateral HTO surgery to asses the additional impact of simultaneous bilateral HTO surgery on the early rehabilitation and recovery of simultaneous bilateral HTO surgery.

Results

3 months after surgery NRS pain scores decreased from 60.5 to 40.9 and subsequently to 30.4 and 24.3 after 6 and 12 months. KOOS-PS scores improved from 50.0 to 44.3 after 3 months, to 33.9 and 29.8 after 6 and 12 months. Lysholms scores did not yet improve after 3 months (45.2 to 44.2), but significantly improved after 6 and 12 months (66.1 and 75.7). Compared to unilateral HTO surgery similar improvements are seen after 6 and 12 months.

Conclusion

Simultaneous bilateral HTO surgery generates similar clinical outcomes compared to unilateral HTO surgery and moreover it does not excessively prolong time to achieve these outcomes . It is safe and presumably a more effective approach to treat patients suffering bilateral medial OA and varus alignment of the knee compared to two-staged surgery.