Effect of osteoarthritis severity on survival and clinical outcomes after high tibial osteotomy
Effect of osteoarthritis severity on survival and clinical outcomes after high tibial osteotomy
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DOI：
10.1016/j.knee.2021.02.031
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发表时间：
2021-03-17
期刊：
影响因子：
1.9
通讯作者：
Okazaki, Ken
中科院分区：
文献类型：
--
作者：
Kuwashima, Umito;Iwasaki, Kenyu;Okazaki, Ken
背景：本研究旨在使用2011年膝关节协会评分(KSS2011)和闭合式胫骨楔形高位截骨术(CWHTO)术后生存率来评估骨关节炎的严重程度对临床结果的影响。方法：在这项回顾研究中，KSS2011问卷邮寄给1991年1月至2011年12月接受CWHTO的患者。对患者收回的完整问卷进行分析。术前骨关节炎严重程度按Kellgren-Lawrence(K-L)评分。KSS2011在K-L分级组之间进行比较。结果：术前K-L评分2、3、4膝分别为16膝、81膝、47膝，以全膝关节置换术时间为终点建立Kaplan-Meier生存曲线。在KSS2011子评分中，症状评分在组间差异有统计学意义(p=0.006)。然而，在满意度、期望值和功能活动评分方面没有发现显著差异。K-L 2组与3组症状积分比较差异无统计学意义(P>；0.05)。18个膝关节接受全膝关节置换术，术后平均9年。根据Kaplan-Meier生存估计，K-L 4组的全膝关节置换中转率显著高于K-L 2组和3组(p<；0.001)。结论：骨性关节炎的严重程度影响了膝关节置换术后长期随访的临床疗效和生存率。当考虑对膝关节内翻患者进行CWHTO时，外科医生应考虑手术前的骨关节炎分级以获得长期结果。(C)2021年爱思唯尔公司版权所有。
Background: This study aimed to evaluate the effect of osteoarthritis severity on clinical outcomes using the 2011 Knee Society Score (KSS2011) and survival rates after closed wedge high tibial osteotomy (CWHTO).Methods: In this retrospective study, KSS2011 questionnaires were mailed to patients who had undergone CWHTO between January 1991 and December 2011. The completed questionnaires returned by the patients were analyzed. Preoperative osteoarthritis severity was evaluated by Kellgren-Lawrence (K-L) grade. KSS2011 was compared between the K-L grade groups. To determine the effect of K-L grade for revision surgery, Kaplan-Meier survival curves were created using the need for total knee arthroplasty (TKA) as the endpoint to estimate the probability of failure.Results: There were 16, 81, and 47 knees with preoperative K-L 2, 3, and 4, respectively. Among the KSS2011 sub-scores, the symptom score showed significant differences between the groups (p = 0.006). However, no significant difference was found regarding satisfaction, expectation, and functional activity scores. No significant difference in the symptom score was found between the K-L 2 and 3 groups (p > 0.05). Eighteen knees were treated with TKA at a mean of 9 years after CWHTO. Using the Kaplan-Meier survival estimates, the K-L 4 group showed a significantly higher rate of total knee arthroplasty conversion than the K-L 2 and 3 groups (p < 0.001).Conclusions: Osteoarthritis severity affects clinical outcomes and survival rates during long-term follow-up after CWHTO. Surgeons should consider the preoperative osteoarthritis grade for long-term outcomes when considering CWHTO for patients with varus knees.(c) 2021 Elsevier B.V. All rights reserved.