High tibial osteotomy accelerates lateral compartment osteoarthritis in discoid meniscus patients.
OBJECTIVE
The valgus high tibial osteotomy (HTO) in patients with medial osteoarthritis and discoid lateral meniscus can result in increased load on the lateral compartment and hence a higher chances of tear. This may accelerate the progression of osteoarthritis on lateral compartment. We, therefore, carried out the case control study with a hypothesis that an HTO would accelerate the progression of osteoarthritis (OA) on lateral compartment in patients with complete discoid meniscus.


METHODS
The records of all patients with open wedge HTO from 2008 to 2012 were evaluated for complete lateral discoid meniscus. The patient who had a valgus HTO with or without partial meniscectomy for medial compartmental OA was included for this study. Cases to control were chosen to match age, body mass index (BMI), pre-operative osteoarthritis grade, and deformity angles in ratio 1:2. Patient's records were studied for demographic data, clinical examination records, and pre-operative knee functional scores and radiological scores and were compared with post-operative data.


RESULTS
Thirty-six patients out of 674 patients, who underwent an HTO, consisted of discoid meniscus group. 72 patients were chosen as control group. Four patients showed progression of OA on the lateral compartment in discoid group compared to none in control group. Although control groups showed a little bit better functional outcomes, there were no statistical differences between two groups (n.s.).


CONCLUSIONS
The high tibial osteotomy could result in accelerated lateral compartment osteoarthritis in patients with complete discoid meniscus, and the procedure should be used with caution in such patients.


METHODS
IV.
Department of Orthopaedic Surgery, Chonnam National University Bitgoeul Hospital, 80, Deongnam-gil, Nam-gu, Gwangju, 503-340, Korea.|Department of Orthopaedic Surgery, Safdarjung hospital and VMMC, New Delhi, 110001, India.
Jatin
J
Prakash
Department of Orthopaedic Surgery, Chonnam National University Bitgoeul Hospital, 80, Deongnam-gil, Nam-gu, Gwangju, 503-340, Korea.
Eun-Kyoo
EK
Song
Department of Orthopaedic Surgery, Chonnam National University Bitgoeul Hospital, 80, Deongnam-gil, Nam-gu, Gwangju, 503-340, Korea.
Hong An
HA
Lim
Department of Orthopaedic Surgery, Chonnam National University Bitgoeul Hospital, 80, Deongnam-gil, Nam-gu, Gwangju, 503-340, Korea.
Young Joo
YJ
Shin
Department of Orthopaedic Surgery, Chonnam National University Bitgoeul Hospital, 80, Deongnam-gil, Nam-gu, Gwangju, 503-340, Korea.
Cheng
C
Jin
Department of Orthopaedic Surgery, Chonnam National University Bitgoeul Hospital, 80, Deongnam-gil, Nam-gu, Gwangju, 503-340, Korea. seonbell@jnu.ac.kr.
Jong-Keun
JK
Seon
D002357:Cartilage Diseases / Q000150:complications / Q000151:congenital / Q000601:surgery*; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D038061:Lower Extremity Deformities, Congenital / Q000150:complications / Q000601:surgery; D008297:Male; D008592:Menisci, Tibial / Q000002:abnormalities*; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D013977:Tibia / Q000601:surgery*
Discoid meniscus; High tibial osteotomy; Primary osteoarthritis; Varus deformity