title: Progression of medial compartmental osteoarthritis 2-8 years after lateral closing-wedge high tibial osteotomy.
abstract: OBJECTIVE
  The primary purpose of this study is to investigate the progression of medial osteoarthritis (OA) following lateral closing-wedge high tibial osteotomy (HTO). Secondary outcomes included functional and pain scores.
  
  
  METHODS
  This prospective cohort study analysed 298 patients treated with lateral closing-wedge HTO surgery for medial compartmental OA. OA progression was measured by comparing the minimum joint space width (mJSW) and Kellgren-Lawrence (KL) score on radiographs preoperatively and postoperatively. The WOMAC score and NRS score for pain were obtained preoperatively and postoperatively to assess secondary outcomes. Failure was defined as revision surgery; survival was estimated.
  
  
  RESULTS
  Mean follow-up was 5.2 ± 1.8 years (range 2-8.5). Mean preoperative mJSW was 3.4 ± 1.6 mm, which changed nonsignificantly (p = 0.51) to 3.4 ± 1.7 mm postoperatively. Mean annual joint space narrowing was 0.02 ± 0.34 mm/year. Progression to 1 KL grade or more was seen in 132 (44 %) patients, and annual risk of KL progression was 8.6 %. No KL progression was seen in 56 % of patients. Mean NRS decreased from 7.3 ± 1.5 to 3.5 ± 2.5 (p < 0.001). WOMAC scores decreased from 48.0 ± 17.2 to 23.6 ± 19.7 (p < 0.001). Failure was seen in 21 patients.
  
  
  CONCLUSIONS
  Compared to demographic data in the literature, valgus high tibial osteotomy seems to reduce the progression of OA, reduces pain and improves knee function in patients with medial compartment OA and a varus alignment.
  
  
  METHODS
  III.
authors.affiliation: Department of Orthopaedic Surgery, Martini Hospital, PO Box 30033, 9700 RM, Groningen, The Netherlands. m.r.huizinga@mzh.nl.
authors.forename: M R
authors.initials: MR
authors.lastname: Huizinga
authors.affiliation: Department of Orthopaedic Surgery, Martini Hospital, PO Box 30033, 9700 RM, Groningen, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Gorter
authors.affiliation: Department of Orthopaedic Surgery, Martini Hospital, PO Box 30033, 9700 RM, Groningen, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Demmer
authors.affiliation: Department of Orthopaedics and General Practice, University Medical Center Rotterdam, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: S M A
authors.initials: SMA
authors.lastname: Bierma-Zeinstra
authors.affiliation: Department of Orthopaedic Surgery, Martini Hospital, PO Box 30033, 9700 RM, Groningen, The Netherlands.
authors.forename: R W
authors.initials: RW
authors.lastname: Brouwer
mesh_terms: D000328:Adult; D000368:Aged; D018450:Disease Progression; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology* / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D017063:Outcome Assessment, Health Care; D011184:Postoperative Period; D011446:Prospective Studies; D011871:Radiology; D013977:Tibia / Q000601:surgery; D013997:Time Factors
keywords: Failure; High tibial osteotomy; Joint space; Osteoarthritis; Progression