Svea Faber1, Peter Angele2,3,4,5, Johannes Zellner6, Gerrit Bode2,3,4,7, Alfred Hochrein1, Philipp Niemeyer1,7. 1. OCM | Orthopädische Chirurgie München, Munich, Germany. 2. Sporthopaedicum, Berlin, Germany. 3. Sporthopaedicum, Straubing, Germany. 4. Sporthopaedicum, Regensburg, Germany. 5. Klinik für Unfallchirurgie, Universitätsklinikum, Regensburg, Bayern, Germany. 6. Klinik für Unfallchirurgie, Caritas-Krankenhaus St. Josef Regensburg, Bayern, Germany. 7. Klinik für Orthopädie und Traumatologie, Universitätsklinikum Freiburg, Baden-Württemberg, Germany.
Abstract
BACKGROUND: Even though realignment procedures have gained popularity as concomitant techniques in cartilage repair approaches with underlying malalignment, the clinical efficacy has not been proven to full extent. METHODS: Out of 5474 patients from the German Cartilage Registry, 788 patients with focal cartilage defects on the medial femoral condyle having received either no accompanying surgery or high tibial osteotomy (HTO) were identified. After a 1:1 propensity score matching, outcome of 440 patients was evaluated using KOOS (Knee Injury and Osteoarthritis Outcome Score), VAS (visual analogue scale), and satisfaction during the 3-year follow-up. RESULTS: Patients having received a concomitant HTO had significantly higher postoperative KOOS values (12 months: 67.26 ± 15.69 vs.75.10 ± 16.12, P = 0.001; 24 months: 67.14 ± 23.85 vs. 77.11 ± 16.50, P = 0.010; 36 months: 74.40 ± 16.57 vs. 81.75 ± 14.22, P = 0.023) and lower pain levels (6 months: 3.43 ± 2.18 vs. 2.89 ± 2.15, P = 0.009; 12 months: 3.64 ± 2.20 vs. 2.17 ± 1.96, P < 0.001; 24 months: 4.20 ± 3.12 vs. 2.94 ± 2.45, P = 0.005; 36 months: 3.20 ± 2.18 vs. 2.02 ± 1.98, P = 0.003). One and 3 years postoperatively, concomitant HTO led to significantly higher satisfaction in patients. These advantages of accompanying HTO were also seen in the group of patients with a varus deformity of 5° or more, in which pain levels without concomitant HTO even increased during the 3-year follow-up. CONCLUSION: The results of the present study underline the importance and safety of concomitant HTO in patients with cartilage defects and varus deformity. HTO should therefore be considered and recommended generously in patients with focal cartilage defects of the medial femoral condyle and varus deformity.
BACKGROUND: Even though realignment procedures have gained popularity as concomitant techniques in cartilage repair approaches with underlying malalignment, the clinical efficacy has not been proven to full extent. METHODS: Out of 5474 patients from the German Cartilage Registry, 788 patients with focal cartilage defects on the medial femoral condyle having received either no accompanying surgery or high tibial osteotomy (HTO) were identified. After a 1:1 propensity score matching, outcome of 440 patients was evaluated using KOOS (Knee Injury and Osteoarthritis Outcome Score), VAS (visual analogue scale), and satisfaction during the 3-year follow-up. RESULTS: Patients having received a concomitant HTO had significantly higher postoperative KOOS values (12 months: 67.26 ± 15.69 vs.75.10 ± 16.12, P = 0.001; 24 months: 67.14 ± 23.85 vs. 77.11 ± 16.50, P = 0.010; 36 months: 74.40 ± 16.57 vs. 81.75 ± 14.22, P = 0.023) and lower pain levels (6 months: 3.43 ± 2.18 vs. 2.89 ± 2.15, P = 0.009; 12 months: 3.64 ± 2.20 vs. 2.17 ± 1.96, P < 0.001; 24 months: 4.20 ± 3.12 vs. 2.94 ± 2.45, P = 0.005; 36 months: 3.20 ± 2.18 vs. 2.02 ± 1.98, P = 0.003). One and 3 years postoperatively, concomitant HTO led to significantly higher satisfaction in patients. These advantages of accompanying HTO were also seen in the group of patients with a varus deformity of 5° or more, in which pain levels without concomitant HTO even increased during the 3-year follow-up. CONCLUSION: The results of the present study underline the importance and safety of concomitant HTO in patients with cartilage defects and varus deformity. HTO should therefore be considered and recommended generously in patients with focal cartilage defects of the medial femoral condyle and varus deformity.
Authors: Daniel B F Saris; Johan Vanlauwe; Jan Victor; Karl Fredrik Almqvist; Rene Verdonk; Johan Bellemans; Frank P Luyten Journal: Am J Sports Med Date: 2009-10-21 Impact factor: 6.202
Authors: Curtis Mina; William E Garrett; Ricardo Pietrobon; Richard Glisson; Laurence Higgins Journal: Am J Sports Med Date: 2008-04-15 Impact factor: 6.202
Authors: Arnd Hoburg; Ingo Löer; Konrad Körsmeier; Rainer Siebold; Philipp Niemeyer; Stefan Fickert; Klaus Ruhnau Journal: Orthop J Sports Med Date: 2019-04-25
Authors: Julian Mehl; Matthias Feucht; Andrea Achtnich; Andreas B Imhoff; Philipp Niemeyer; Peter Angele; Wolfgang Zinser; Gunter Spahn; Ingo Loer; Heino Kniffler; Gunnar Schauf; Andreas Schmitt Journal: Knee Surg Sports Traumatol Arthrosc Date: 2021-10-09 Impact factor: 4.114
Authors: Maximilian Hinz; Christoph Lutter; Ralf Mueller-Rath; Philipp Niemeyer; Oliver Miltner; Thomas Tischer Journal: Knee Surg Sports Traumatol Arthrosc Date: 2022-09-25 Impact factor: 4.114