Age predicts outcome of high-tibial osteotomy.
This study compares the predictive value of age at surgery in high tibial osteotomy. Twenty-seven high-tibial osteotomies in patients who are 65 years or older (mean age at surgery 68+/-4 years, follow up 12+/-2 years) were compared to 67 osteotomies in patients younger than 65 years (mean age at surgery 56+/-6 years, follow up 13+/-3) with respect to the outcome by Cox regression analysis. Failure, i.e. endpoint, was defined as implantation of a knee endoprosthesis and assessed by Kaplan-Meier analysis. There is a significantly higher risk for failure of high tibial osteotomies in patients of 65 years or more compared to younger patients (failure rate 38.4+/-11.3% vs. 23.1+/-5.8%) resulting in a relative risk of 1.5 (P=0.0461). The hazard of failure increased 7.6% per year of age. We conclude that in regard to the increasing risk of failure per year of age and the higher failure rate in older patients, high-tibial osteotomy should not be performed on patients older than 65 years.
Trieb
K
K
Department of Orthopedics, University of Vienna, Austria. k.trieb.co@klinikumffo.de
Grohs
J
J
Hanslik-Schnabel
B
B
Stulnig
T
T
Panotopoulos
J
J
Wanivenhaus
A
A
D000328:Adult; D000367:Age Factors; D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D007720:Knee Prosthesis; D008875:Middle Aged; D010027:Osteotomy / Q000009:adverse effects* / Q000379:methods; D012044:Regression Analysis; D013977:Tibia / Q000601:surgery*; D017211:Treatment Failure