Download PDF
J Knee Surg 2023; 36(03): 261-268
DOI: 10.1055/s-0041-1731738
Original Article

Short-Term Outcomes after High Tibial Osteotomy Aimed at Neutral Alignment Combined with Arthroscopic Centralization of Medial Meniscus in Osteoarthritis Patients

Hiroki Katagiri
1   Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
2   Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, Bunkyo-ku, Tokyo, Japan
,
Yusuke Nakagawa
1   Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
2   Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, Bunkyo-ku, Tokyo, Japan
,
Kazumasa Miyatake
1   Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
2   Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, Bunkyo-ku, Tokyo, Japan
,
Toshiyuki Ohara
2   Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, Bunkyo-ku, Tokyo, Japan
,
Mikio Shioda
2   Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, Bunkyo-ku, Tokyo, Japan
,
Ichiro Sekiya
3   Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Bunkyo-ku, Tokyo, Japan
,
Hideyuki Koga 
1   Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
2   Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, Bunkyo-ku, Tokyo, Japan
› Author Affiliations Funding None.
› Further Information
    Permissions and Reprints

Abstract

The study aimed to improve the long-term outcomes of open-wedge high tibial osteotomy (OWHTO); procedures combining OWHTO aimed at neutral alignment and arthroscopic centralization for meniscal extrusion have been introduced. The present study evaluated short-term patient-reported outcome measures; namely, the patient subjective satisfaction scores and Numeric Rating Scale (NRS) for walking pain after OWHTO aimed at neutral alignment with and without arthroscopic centralization for an extruded medial meniscus. A retrospective review of 50 primary OWHTO patients was conducted. Thirty-nine patients were included in the analysis after applying the exclusion criteria. The centralization group included 21 patients with knee osteoarthritis patients who underwent the OWHTO with arthroscopic meniscal centralization, while the control group included 18 patients who underwent OWHTO alone. The patient subjective satisfaction scores and NRS for walking pain were recorded at outpatient visits from before surgery to 3 years after surgery. In terms of the Lysholm knee scale, International Knee Documentation Committee subjective score, and Knee Osteoarthritis Outcome Score, the latest data (at least 2 years after surgery) were reviewed. Radiographic changes in joint space width and joint line congruence angle were measured 2 years postoperatively. Patient demographic data were also reviewed. One patient in the centralization group experienced a superficial surgical site infection. The patient subjective satisfaction and NRS scores for walking pain gradually improved by 1 year after surgery and were sustained until 3 years after surgery in both groups, with no significant difference between the groups. The course of patient-reported outcome measures from before surgery to 3 years after surgery for solely OWHTO aimed at neutral alignment and OWHTO aimed at neutral alignment with arthroscopic centralization showed the similar trends.

Keywords

high tibial osteotomy - meniscus - arthroscopic centralization

Note

This study was conducted at Tokyo Medical and Dental University Hospital of Medicine.


Authors' Contributions

H.K. conceived the study and performed all experiments and participated in its design. K.M. participated in its design and performed analysis. Y.N. acquired the data. T.O. and M.S. analyzed and calculated the data. I.S. participated in its design. H.K. had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. All authors read, approved the final manuscript, and took responsibility for the integrity of the data and the accuracy of the data analysis.




Publication History

Received: 18 July 2020

Accepted: 31 May 2021

Article published online:
14 July 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Niinimäki TT, Eskelinen A, Mann BS, Junnila M, Ohtonen P, Leppilahti J. Survivorship of high tibial osteotomy in the treatment of osteoarthritis of the knee: Finnish registry-based study of 3195 knees. J Bone Joint Surg Br 2012; 94 (11) 1517-1521
    CrossrefPubMedGoogle Scholar
  • 2 W-Dahl A, Robertsson O, Lohmander LS. High tibial osteotomy in Sweden, 1998-2007: a population-based study of the use and rate of revision to knee arthroplasty. Acta Orthop 2012; 83 (03) 244-248
    CrossrefPubMedGoogle Scholar
  • 3 Song SJ, Bae DK, Kim KI, Lee CH. Conversion total knee arthroplasty after failed high tibial osteotomy. Knee Surg Relat Res 2016; 28 (02) 89-98
    CrossrefPubMedGoogle Scholar
  • 4 Berthiaume MJ, Raynauld JP, Martel-Pelletier J. et al. Meniscal tear and extrusion are strongly associated with progression of symptomatic knee osteoarthritis as assessed by quantitative magnetic resonance imaging. Ann Rheum Dis 2005; 64 (04) 556-563
    CrossrefPubMedGoogle Scholar
  • 5 Roubille C, Martel-Pelletier J, Raynauld JP. et al. Meniscal extrusion promotes knee osteoarthritis structural progression: protective effect of strontium ranelate treatment in a phase III clinical trial. Arthritis Res Ther 2015; 17: 82
    CrossrefPubMedGoogle Scholar
  • 6 Luczkiewicz P, Daszkiewicz K, Witkowski W, Chróścielewski J, Ferenc T, Baczkowski B. The influence of a change in the meniscus cross-sectional shape on the medio-lateral translation of the knee joint and meniscal extrusion. PLoS One 2018; 13 (02) e0193020
    CrossrefPubMedGoogle Scholar
  • 7 Koga H, Watanabe T, Horie M. et al. Augmentation of the pullout repair of a medial meniscus posterior root tear by arthroscopic centralization. Arthrosc Tech 2017; 6 (04) e1335-e1339
    CrossrefPubMedGoogle Scholar
  • 8 Koga H, Muneta T, Yagishita K. et al. Arthroscopic centralization of an extruded lateral meniscus. Arthrosc Tech 2012; 1 (02) e209-e212
    CrossrefPubMedGoogle Scholar
  • 9 Koga H, Muneta T, Watanabe T. et al. Two-Year outcomes after arthroscopic lateral meniscus centralization. Arthroscopy 2016; 32 (10) 2000-2008
    CrossrefPubMedGoogle Scholar
  • 10 Ozeki N, Muneta T, Kawabata K. et al. Centralization of extruded medial meniscus delays cartilage degeneration in rats. J Orthop Sci 2017; 22 (03) 542-548
    CrossrefPubMedGoogle Scholar
  • 11 Costa CR, Morrison WB, Carrino JA. Medial meniscus extrusion on knee MRI: is extent associated with severity of degeneration or type of tear?. AJR Am J Roentgenol 2004; 183 (01) 17-23
    CrossrefPubMedGoogle Scholar
  • 12 Nguyen JC, De Smet AA, Graf BK, Rosas HG. MR imaging-based diagnosis and classification of meniscal tears. Radiographics 2014; 34 (04) 981-999
    CrossrefPubMedGoogle Scholar
  • 13 Staubli AE, De Simoni C, Babst R, Lobenhoffer P. TomoFix: a new LCP-concept for open wedge osteotomy of the medial proximal tibia--early results in 92 cases. Injury 2003; 34 (Suppl. 02) B55-B62
    CrossrefPubMedGoogle Scholar
  • 14 Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33 (01) 159-174
    Google Scholar
  • 15 Rath E, Richmond JC. The menisci: basic science and advances in treatment. Br J Sports Med 2000; 34 (04) 252-257
    CrossrefPubMedGoogle Scholar
  • 16 Fukubayashi T, Kurosawa H. The contact area and pressure distribution pattern of the knee. A study of normal and osteoarthrotic knee joints. Acta Orthop Scand 1980; 51 (06) 871-879
    CrossrefPubMedGoogle Scholar
  • 17 Hein CN, Deperio JG, Ehrensberger MT, Marzo JM. Effects of medial meniscal posterior horn avulsion and repair on meniscal displacement. Knee 2011; 18 (03) 189-192
    CrossrefPubMedGoogle Scholar
  • 18 Hada S, Ishijima M, Kaneko H. et al. Association of medial meniscal extrusion with medial tibial osteophyte distance detected by T2 mapping MRI in patients with early-stage knee osteoarthritis. Arthritis Res Ther 2017; 19 (01) 201
    CrossrefPubMedGoogle Scholar
  • 19 Ozeki N, Koga H, Matsuda J. et al. Biomechanical analysis of the centralization procedure for extruded lateral menisci with posterior root deficiency in a porcine model. J Orthop Sci 2020; 25 (01) 161-166
    CrossrefPubMedGoogle Scholar
  • 20 Bode G, von Heyden J, Pestka J. et al. Prospective 5-year survival rate data following open-wedge valgus high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 2015; 23 (07) 1949-1955
    CrossrefPubMedGoogle Scholar
  • 21 Schröter S, Gonser CE, Konstantinidis L, Helwig P, Albrecht D. High complication rate after biplanar open wedge high tibial osteotomy stabilized with a new spacer plate (Position HTO plate) without bone substitute. Arthroscopy 2011; 27 (05) 644-652
    CrossrefPubMedGoogle Scholar
  • 22 Niemeyer P, Schmal H, Hauschild O, von Heyden J, Südkamp NP, Köstler W. Open-wedge osteotomy using an internal plate fixator in patients with medial-compartment gonarthritis and varus malalignment: 3-year results with regard to preoperative arthroscopic and radiographic findings. Arthroscopy 2010; 26 (12) 1607-1616
    CrossrefPubMedGoogle Scholar
  • 23 Bastard C, Mirouse G, Potage D. et al. Return to sports and quality of life after high tibial osteotomy in patients under 60 years of age. Orthop Traumatol Surg Res 2017; 103 (08) 1189-1191
    CrossrefPubMedGoogle Scholar
  • 24 Tang WC, Henderson IJ. High tibial osteotomy: long term survival analysis and patients' perspective. Knee 2005; 12 (06) 410-413
    CrossrefPubMedGoogle Scholar
  • 25 Sterett WI, Steadman JR, Huang MJ, Matheny LM, Briggs KK. Chondral resurfacing and high tibial osteotomy in the varus knee: survivorship analysis. Am J Sports Med 2010; 38 (07) 1420-1424
    CrossrefPubMedGoogle Scholar
  • 26 Ozkaya U, Kabukçuoğlu Y, Parmaksizoğlu AS, Yeniocak S, Ozkazanli G. [Changes in patellar height and tibia inclination angle following open-wedge high tibial osteotomy]. Acta Orthop Traumatol Turc 2008; 42 (04) 265-271
    CrossrefPubMedGoogle Scholar
  • 27 Miller BS, Joseph TA, Barry EM, Rich VJ, Sterett WI. Patient satisfaction after medial opening high tibial osteotomy and microfracture. J Knee Surg 2007; 20 (02) 129-133
    Article in Thieme ConnectPubMedGoogle Scholar
  • 28 DeMeo PJ, Johnson EM, Chiang PP, Flamm AM, Miller MC. Midterm follow-up of opening-wedge high tibial osteotomy. Am J Sports Med 2010; 38 (10) 2077-2084
    CrossrefPubMedGoogle Scholar
  • 29 Kohn L, Sauerschnig M, Iskansar S. et al. Age does not influence the clinical outcome after high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 2013; 21 (01) 146-151
    CrossrefPubMedGoogle Scholar
  • 30 Ribeiro CH, Severino NR, Moraes de Barros Fucs PM. Opening wedge high tibial osteotomy: navigation system compared to the conventional technique in a controlled clinical study. Int Orthop 2014; 38 (08) 1627-1631
    CrossrefPubMedGoogle Scholar
  • 31 Vedi V, Williams A, Tennant SJ, Spouse E, Hunt DM, Gedroyc WM. Meniscal movement. An in-vivo study using dynamic MRI. J Bone Joint Surg Br 1999; 81 (01) 37-41
    CrossrefPubMedGoogle Scholar
  • 32 Lerer DB, Umans HR, Hu MX, Jones MH. The role of meniscal root pathology and radial meniscal tear in medial meniscal extrusion. Skeletal Radiol 2004; 33 (10) 569-574
    CrossrefPubMedGoogle Scholar
  • 33 Edwards C, Goldman BH, Turley J, Richey B, Deal MJ, Kalbac D. Outcomes after surgical repair of medial meniscal root tears: a review. J Knee Surg 2021; 34 (14) 1599-1602
    Article in Thieme ConnectPubMedGoogle Scholar
  • 34 Bernard CD, Kennedy NI, Tagliero AJ. et al. Medial meniscus posterior root tear treatment: a matched cohort comparison of nonoperative management, partial meniscectomy, and repair. Am J Sports Med 2020; 48 (01) 128-132
    CrossrefPubMedGoogle Scholar
  • 35 Lee OS, Lee SH, Lee YS. Comparison of the radiologic, arthroscopic, and clinical outcomes between repaired versus unrepaired medial meniscus posterior horn root tear during open wedge high tibial osteotomy. J Knee Surg 2021; 34 (01) 57-66
    Article in Thieme ConnectPubMedGoogle Scholar
  • 36 Ke X, Qiu J, Chen S. et al. Concurrent arthroscopic meniscal repair during open-wedge high tibial osteotomy is not clinically beneficial for medial meniscus posterior root tears. Knee Surg Sports Traumatol Arthrosc 2021; 29 (03) 955-965
    CrossrefPubMedGoogle Scholar
  • 37 Fujisawa Y, Masuhara K, Shiomi S. The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop Clin North Am 1979; 10 (03) 585-608
    CrossrefPubMedGoogle Scholar
  • 38 Felson DT, Niu J, Gross KD. et al. Valgus malalignment is a risk factor for lateral knee osteoarthritis incidence and progression: findings from the multicenter osteoarthritis study and the osteoarthritis initiative. Arthritis Rheum 2013; 65 (02) 355-362
    CrossrefPubMedGoogle Scholar
  • 39 Prakash J, Song EK, Lim HA, Shin YJ, Jin C, Seon JK. High tibial osteotomy accelerates lateral compartment osteoarthritis in discoid meniscus patients. Knee Surg Sports Traumatol Arthrosc 2018; 26 (06) 1845-1850
    CrossrefPubMedGoogle Scholar
  • 40 Nakayama H, Schröter S, Yamamoto C. et al. Large correction in opening wedge high tibial osteotomy with resultant joint-line obliquity induces excessive shear stress on the articular cartilage. Knee Surg Sports Traumatol Arthrosc 2018; 26 (06) 1873-1878
    CrossrefPubMedGoogle Scholar
  • 41 Harris JD, Brand JC, Cote MP, Faucett SC, Dhawan A. Research pearls: the significance of statistics and perils of pooling. part 1: clinical versus statistical significance. Arthroscopy 2017; 33 (06) 1102-1112
    CrossrefPubMedGoogle Scholar
  • 42 Jin C, Song EK, Santoso A, Ingale PS, Choi IS, Seon JK. Survival and risk factor analysis of medial open wedge high tibial osteotomy for unicompartment knee osteoarthritis. Arthroscopy 2020; 36 (02) 535-543
    CrossrefPubMedGoogle Scholar
  • 43 Lee SJ, Kim JH, Choi W. Factors related to the early outcome of medial open wedge high tibial osteotomy: coronal limb alignment affects more than cartilage degeneration state. Arch Orthop Trauma Surg 2021; 141 (08) 1339-1348
    CrossrefPubMedGoogle Scholar