Early Loading after Closed Wedge High Tibial Osteotomy for Knee Arthritis (original) (raw)
2015, Sports and Exercise Medicine - Open Journal
Operative treatment approaches for the arthritis in the medial tibiofemoral compartment combined with a varus deformation of the knee are closed wedge high tibial osteotomy or knee arthroplasty. In contrast to the knee arthroplasty, tibial osteotomy maintains primary the function of natural knee joint. However, the limitations of the method are the necessity of postoperative immobilization, late term of loading and long period of functional recovery. The study on early loading after closed wedge high tibial osteotomy as the treatment of knee arthrosis was initiated. Two group of different postoperative rehabilitation approach were allocated. The first group included 22 patients in whom the loading was applied after 6 th postoperative week, and the second group included 15 patients with early weight bearing at 3 rd-5 th postoperative day. Estimation of complications and comparison of the results of the treatment in two groups was carried out. The short-and long-term results of the treatment in the both groups showed similar distribution of good and poor result without significant differences. Studying rehabilitation dynamic, early loading allowed for faster postoperative functional recovery. No statistically significant differences regarding postoperative complications between the groups were observed. Our results indicate that early weight bearing after high tibial osteotomy does not worsen process of rehabilitation and result of the treatment. The absence of statistical differences regarding postoperative complications indicates the safety of the approach. In conclusion, we assumed that after closed wedge high tibial osteotomy the early postoperative loading is an advantageous rehabilitation approach in comparison with the late loading due to a faster functional recovery and a shortening of the patient hospitalisation. Nevertheless, further multipatient studies on this approach with similar long-term follow ups are necessary.
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High Tibial Osteotomy: Long Term Follow-Up
International Journal of Current Research and Academic Review, 2016
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Functional Outcome of High Tibial Lateral Closed Wedge Osteotomy in Osteoarthritis
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High tibial osteotomy: closed wedge versus combined wedge osteotomy
BMC Musculoskeletal Disorders, 2014
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The Knee, 2014
Background: High tibial osteotomy (HTO) for medial knee osteoarthritis (OA) is mainly performed via two procedures: closed wedge HTO (CW) and opening wedge HTO (OW). In this study, differences between these procedures were assessed by serial clinical evaluation and gait analysis before and after surgery. Methods: Twenty-one patients underwent HTO for medial knee OA in 2011 and 2012, with 12 patients undergoing CW and 9 undergoing OW. The severity of OA was classified according to the Kellgren-Lawrence classification. The Japanese Orthopedic Association score for assessment of knee OA (JOA score), the Numeric Rating Scale (NRS), and femoral tibial angle (FTA) on X-ray were evaluated. For gait analysis, gait speed, varus moment, varus angle and lateral thrust were calculated. Results: The JOA score and NRS were improved significantly 1 year postoperatively in both groups. The FTA was maintained in both groups at 1 year. Varus angle and varus moment were significantly improved in both groups at each postoperative follow-up, compared to preoperatively. Lateral thrust was significantly improved 3 months postoperatively in both groups. However, the significant improvement in lateral thrust had disappeared in the CW group 6 months postoperatively, whereas it was maintained for at least 1 year in the OW group. Conclusions: This study found that clinical outcomes were well maintained after HTO. OW reduced knee varus moment and lateral thrust, whereas CW had little effect on reducing lateral thrust.
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