title: Health-related quality of life after open-wedge high tibial osteotomy.
abstract: OBJECTIVE
  (1) To monitor longitudinal changes in health-related quality of life (HRQOL), pain, knee function, and return to work (RtW) following high tibial osteotomy (HTO) for medial compartment osteoarthritis (OA), and (2) to investigate the influences of psychopathological comorbidities on preoperative impairment and post-operative course.
  
  
  METHODS
  Sixty-four patients were prospectively followed for 24 months after HTO to determine HRQOL, pain, functional outcome, and RtW. Psychopathological comorbidities (e.g. depression) were determined preoperatively. Patients with no psychological distress (ND) were compared to patients with psychological distress (PD) in order to investigate the influence of psychopathological comorbidities on outcome.
  
  
  RESULTS
  There was a significant increase in HRQOL and decrease in pain from 6 month follow-up on. Functional outcomes increased significantly from 12 month follow-up on. In general, there was a steady state of outcomes from 6- to 12-month follow-up on. At final follow-up, 90 % returned to their previous occupation without limitations. Mental component summary (MCS) and functional outcome showed a positive correlation with RtW, while depression had a negative one. A significantly inferior outcome of group PD versus ND was observed at baseline and early follow-up. RtW was significantly prolonged in group PD (8.9 ± 7.6 vs. 3.9 ± 3 months; p < 0.001). At final follow-up, both groups presented with comparable outcomes.
  
  
  CONCLUSIONS
  HTO for medial compartment OA significantly improves HRQOL, pain, and knee function. Time to RtW is high and critically depends on PD. Further, extend of preoperative impairments, an initially inferior course, and inferior MCS outcome was influenced by PD. However, otherwise no significant differences were observed between groups PD and ND at final follow-up.
  
  
  METHODS
  Prospective case series, II.
authors.affiliation: Department of Orthopedic Sports Medicine, Klinikum rechts der Isar, Technische Universtität München, 81679, Munich, Germany.|Department of Traumatology and Reconstructive Joint Surgery, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau am Staffelsee, Germany.
authors.forename: Tim
authors.initials: T
authors.lastname: Saier
authors.affiliation: Department of Orthopedic Sports Medicine, Klinikum rechts der Isar, Technische Universtität München, 81679, Munich, Germany.|Chirurgische Klinik Dr. Rinecker, Munich, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Minzlaff
authors.affiliation: Department Orthopedics and Traumatology, University of Freiburg, Freiburg, Germany.
authors.forename: Matthias J
authors.initials: MJ
authors.lastname: Feucht
authors.affiliation: MSH Medical School Hamburg, Hamburg, Germany.
authors.forename: Lena
authors.initials: L
authors.lastname: Lämmle
authors.affiliation: Department of Orthopedic Sports Medicine, Klinikum rechts der Isar, Technische Universtität München, 81679, Munich, Germany.
authors.forename: Maike
authors.initials: M
authors.lastname: Burghoff
authors.affiliation: Department of Traumatology and Reconstructive Surgery, BG Traumacenter Tübingen, University of Tübingen, Tübingen, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Ihle
authors.affiliation: Department of Orthopedic Sports Medicine, Klinikum rechts der Isar, Technische Universtität München, 81679, Munich, Germany. a.imhoff@lrz.tum.de.
authors.forename: Andreas B
authors.initials: AB
authors.lastname: Imhoff
authors.affiliation: Department of Orthopedic Sports Medicine, Klinikum rechts der Isar, Technische Universtität München, 81679, Munich, Germany.|OrthoPlus Germany, Munich, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Hinterwimmer
mesh_terms: D000328:Adult; D003863:Depression / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000502:physiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000523:psychology / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D010146:Pain / Q000517:prevention & control; D011446:Prospective Studies; D011788:Quality of Life; D013315:Stress, Psychological / Q000150:complications; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: High tibial osteotomy; Knee; Osteoarthritis; Quality of life; Return to work