Functional outcomes of high tibial osteotomy for symptomatic medial compartment osteoarthritis in middle-aged patients-both prospective and retrospective study in Indian population in the quaternary care center

Abstract

Background: High Tibial osteotomy is a surgical procedure to reposition the mechanical axis of a painful varus knee into a slightly valgus one, which minimizes joint tenderness and also decreases the rate of cartilage degeneration so the joint replacement surgery can be postponed. Materials & Methods: 500 patients were evaluated in the study. The study population included patients who underwent HTO at Manipal Hospital, Bangalore & those who came for follow-up after surgery during the period 2008 to 2017. An X-ray scanogram was done pre-operatively & post-operatively to assess the correction. Visual analogue score and Knee society score are used to evaluate the functional outcome. Results: The mean follow-up was 5 years. All the patients showed significant improvement in their postoperative scores. The mean age of the patients in our study at the time of surgery was 46.7 & sex distribution was 55.6% and 44.4% in Females and Males respectively. 44.4 % of the patients underwent left-sided HTO and 55.6 % of the patients were right HTO. The mean BMI was 25.5, the minimum was 19.3 & the maximum was 30.1. 47.2% of patients had normal BMI. The overall complication rate was 4.8% in our study. These complications include Delayed Union (2.4%), Stiffness of the knee (1.6%) and only 4 patients required revision to TKR (0.8%) at 5 years follow-up. The longest follow-up was 14 years and the minimum follow-up was 5 years. All these complications were manageable conservatively as all these complications were minor, and none of the patients required revision surgery. The visual analogue scale (VAS) was used to assess pain both preoperatively and postoperatively. The VAS and KSS scores significantly improved after surgery (p