Effect of Patient Age on Clinical and Radiological Outcomes After Medial Open-Wedge High Tibial Osteotomy: A Comparative Study With 344 Knees

Koji Yabuuchi; Eiji Kondo; Takuma Kaibara; Jun Onodera; Koji Iwasaki; Masatake Matsuoka; Tomohiro Onodera; Norimasa Iwasaki; Tomonori Yagi; Kazunori Yasuda

doi:10.1177/23259671231200227

Effect of Patient Age on Clinical and Radiological Outcomes After Medial Open-Wedge High Tibial Osteotomy: A Comparative Study With 344 Knees

Orthop J Sports Med. 2023 Oct 12;11(10):23259671231200227. doi: 10.1177/23259671231200227. eCollection 2023 Oct.

Authors

Affiliations

¹ Department of Orthopaedic Surgery, Yagi Orthopaedic Hospital, Sapporo, Hokkaido, Japan.
² Centre for Sports Medicine, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.
³ Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.

Abstract

Background: There exists some controversy regarding whether patient age is a predictive factor for outcomes after high tibial osteotomy (HTO).

Purpose/hypothesis: The purpose of this study was to evaluate whether patient age affects clinical and radiological outcomes after medial open-wedge HTO (OWHTO) in a large population with a wider age range than previous studies. It was hypothesized that there would be no differences in outcomes when compared across age-groups.

Study design: Cohort study; Level of evidence, 3.

Methods: A retrospective comparative study was conducted using 344 patients (303 knees) who underwent OWHTO from 2009 to 2018. These patients were divided into 3 groups based on age at the time of surgery: ≥55 years (group Y: 76 knees in 57 patients), 56 to 64 years (group M: 129 knees in 120 patients), and ≤65 years (group O: 139 knees in 126 patients). Clinical and radiological evaluations were performed immediately before surgery and at the final follow-up period, at a mean of 5.1 years (range, 3-11 years). Comparisons among the 3 groups were conducted with 1-way analysis of variance for continuous variables. When a significant result was obtained, a post hoc test with Bonferroni correction was conducted for multiple comparisons.

Results: In clinical evaluations, there were no significant differences among the 3 groups either preoperatively or postoperatively concerning the Japanese Orthopaedic Association score, the Lysholm score, or the Knee injury and Osteoarthritis Outcome Score (KOOS), with the exception of the preoperative KOOS Symptoms subscale, which was significantly higher in group Y versus group O (48.9 ± 18.7 vs 58.7 ± 15.4, respectively; P = .011). The Tegner activity score was significantly different among the groups, both preoperatively and postoperatively (P < .001 for both). There was no significant difference in the occurrence of complications or the survival rate at final follow-up among the 3 groups.

Conclusion: The study findings suggest that patient age does not affect clinical and radiological outcomes after OWHTO.

Keywords: age; clinical outcome; high tibial osteotomy; open wedge; osteoarthritis.