Objective: The purpose of this study was to evaluate sporting activity and clinical outcome following medial open-wedge high tibial osteotomy (OWHTO) in middle and older-aged patients with medial osteoarthritis (OA).
Methods: Between 2009 and 2014, 22 patients (25 knees) who underwent OWHTO with a locking plate were enrolled in this study. All patients were active in sports on a regular basis prior to surgery, but were unable to perform sports at the time of surgery. Inclusion criteria involved patients who had medial OA or spontaneous osteonecrosis of the knee. There were 10 men and 12 women with a mean age of 60.3 years (range: 41-74 years) at the time of surgery. We performed a biplanar osteotomy of the tibia intraoperatively. A beta-TCP spacer was implanted in the opening space. Then, a locking plate was implanted onto the tibia. All patients underwent sporting activities, clinical and radiological examinations, with determinations of complications prior to surgery and at the final follow up periods after surgery (mean 37.2 months, range: 13.0-73.1 months).
Results: Postoperatively, the mean Japan Orthopaedic Association score significantly improved from 68.2 to 92.6 points (Total score: 100 points, P<0.001). The Tegner activity level scale did not show significant changes pre- and postoperatively (4.1 to 3.8). However, three patients who engaged in high impact sports (competitive skiing and marathon) had decreased Tegner activity level scale after surgery.
Conclusion: The present study has demonstrated that OWHTO for the treatment of OA in middle and older-aged patients significantly improved the short-term clinical outcome and allowed patients to return to sporting activities similar to their preoperative levels.
