title: A preference-based single-item measure of quality of life following medial opening wedge high tibial osteotomy: large improvements similar to arthroplasty.
abstract: BACKGROUND
  Improvements in generic and disease specific scores have been reported with medial opening wedge high tibial osteotomy (MOW HTO). However, meaningful comparisons between competing surgical interventions have been hampered by the lack of a preference based single index of health related quality of life (HRQoL). The primary aim of this study was to derive and report a single index measure of HRQoL for patients undergoing MOW HTO, preoperatively and at 12 and 24 postoperatively. Secondary aims were to evaluate changes in various additional measures of quality of life at these time points.
  
  
  METHODS
  The impact of MOW HTO was evaluated using generic and disease specific instruments. One hundred thirty eight patients completed the Medical Outcomes Study short form health survey (SF-12) and Knee Osteoarthritis Outcomes Score (KOOS) before, 12 and 24 months after surgery. A preference-based single index measure of HRQoL was calculated and changes were evaluated.
  
  
  RESULTS
  The mean change in the HRQoL suggested large, clinically significant improvements from 0.69 preoperatively to 0.82 (p<0.001) and 0.8 at 12 and 24 months postoperatively respectively. All dimensions of the SF-12, except role mental health, and all dimensions of the KOOS also demonstrated statistically significant improvements between pre and postoperative measurements.
  
  
  CONCLUSIONS
  The preoperative HRQoL of young patients with mechanical varus alignment and medial compartment knee osteoarthritis is similar to older patients with knee osteoarthritis. Medial opening wedge high tibial osteomoty results in significant improvements in HRQoL, the magnitude of which is comparable to other surgical interventions for knee osteoarthristis.
authors.affiliation: Norfolk and Norwich University Hospital NHS foundation trust, University of East Anglia, UK. Electronic address: imcnamara@doctors.org.uk.
authors.forename: Iain R
authors.initials: IR
authors.lastname: McNamara
authors.affiliation: Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, ON Canada.
authors.forename: Trevor B
authors.initials: TB
authors.lastname: Birmingham
authors.affiliation: Health Economics Research Unit, St. Michael's Hospital, Toronto, ON, Canada. Electronic address: jmarsh2@uwo.ca.
authors.forename: Jacquelyn D
authors.initials: JD
authors.lastname: Marsh
authors.affiliation: Schulich School of Medicine, University of Western Ontario, London, ON Canada.
authors.forename: Bert M
authors.initials: BM
authors.lastname: Chesworth
authors.affiliation: Schulich School of Medicine, University of Western Ontario, London, ON Canada.
authors.forename: Dianne M
authors.initials: DM
authors.lastname: Bryant
authors.affiliation: Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, ON Canada; Schulich School of Medicine, University of Western Ontario, London, ON Canada.
authors.forename: J Robert
authors.initials: JR
authors.lastname: Giffin
mesh_terms: D005260:Female; D006801:Humans; D016916:Joint Deformities, Acquired / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013977:Tibia / Q000601:surgery*
keywords: Health related quality of life; Medial opening wedge high tibial osteotomy