COPENHAGEN, Denmark High tibial osteotomy appears to postpone
total knee replacement in young osteoarthritis patients for 10 years or more,
according to a study presented here.
The findings were shared by Annette W-Dahl, PhD, at the 12th EFORT
As there is no national registration of high tibial osteotomies
corresponding to the registration of knee arthroplasties, we have insufficient
knowledge about the results after high tibial osteotomy, W-Dahl said.
Conversion of an osteotomy to a knee replacement can be considered a
measure of failure. Published results have shown conversion rates of 10 years
between 8% and 49%, however, these studies have been based on relatively few
W-Dahl and her team identified 3,196 high tibial osteotomy patients 30
years or older through inpatient and outpatient care registers from the Swedish
National Board of Health and Welfare. These surgical records were used to
determine the operated side, as well as the diagnosis and indications for
surgery. The team used the Swedish Knee Arthroplasty Register to identify any
conversions of high tibial osteotomy to knee arthroplasty.
Mean age in the cohort was 52 years, with 97% of patients registering as
younger than 65 years of age. At the 10-year mark following adjustments for age
and gender, W-Dahl noted, the cumulative revision rate was 29.4%. Increasing
age was a factor in increased risk of revision, with adjustments for age
revealing a risk of revision that was significantly higher in women.
The authors noted in the study that the success rates indicate high
tibial osteotomy could potentially be considered an alternative to total knee
arthroplasty in younger, physically active patients.
Seventy percent of high tibial osteotomies were not converted to
arthroplasties after 10 years, and this must be regarded as a success since
high tibial osteotomy postpones total knee replacement for 10 years or more in
the majority of young osteoarthritis patients, W-Dahl said.
- W-Dahl A, Robertsson O, Lohmander S. Knee arthroplasty after high
tibial osteotomy in Sweden 1998-2007. Paper #918. Presented at the 12th EFORT
Congress 2011. June 1-4. Copenhagen, Denmark.
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