The following is a summary of “Responders to Medial Opening Wedge High Tibial Osteotomy for Knee Osteoarthritis,” published in the June 2023 issue of Rheumatology by Primeau et al.
Medial opening wedge high tibial osteotomy (HTO) aims to alleviate symptoms in patients with knee osteoarthritis (OA) and varus alignment; however, the probability of attaining a minimum clinical threshold of response and the factors predictive of response are unknown. Two years after medial opening wedge HTO, researchers evaluated the proportion of patients meeting responder criteria based on the Outcome Measures in Rheumatology–Osteoarthritis Research Society International consensus and investigated predictors of response.
A prospective cohort of patients with symptomatic knee OA and varus alignment completed the Knee Injury and Osteoarthritis Outcome Score questionnaire 3 months before and 2 years after HTO. For their primary analysis, they determined the proportion of responders with a relative improvement of 20% and an absolute change from a baseline of 10 points in pain and function. They utilized logistic regression to assess the relationship between predictors and response and gender-specific analyses. At a mean of 20,3 (SD 6,2) months post-HTO, 406 (78%) patients met responder criteria. Although odds ratios were modest, older age, higher BMI, and larger postoperative mechanical axis angles (i.e., slight valgus) were associated with increased odds of meeting responder criteria.
About 78% of male patients (316/405) and 76% of female patients (90/118) met the responder criteria when stratified by gender. Based on responder criteria for knee OA, 78% of patients who underwent medial opening wedge HTO at 2 years post-surgery were responders. Although youthful, male, and nonobese patients are considered ideal candidates for HTO, patients who are female, older, and have a high BMI also experience significant pain and function improvements.
Source: jrheum.org/content/50/6/809
