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

J Knee Surg. 2021 Jul 14. doi: 10.1055/s-0041-1731738. Online ahead of print.

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.