Health-Related Quality of Life – an Underestimated Factor to Evaluate the Treatment Success after Open Wedge HTO Surgery: Prospective 6-Years Follow-Up

Moritz Herbst; Umito Kuwashima; Marc-Daniel Ahrend; Boyko Guergov Gueorguiev; Steffen Schröter; Christoph Ihle

doi:10.1055/a-1098-8894

Zeitschrift für Orthopädie und Unfallchirurgie, Table of Contents

Z Orthop Unfall 2021; 159(03): 288-297
DOI: 10.1055/a-1098-8894

Original Article/Originalarbeit

Health-Related Quality of Life – an Underestimated Factor to Evaluate the Treatment Success after Open Wedge HTO Surgery: Prospective 6-Years Follow-Up

Article in several languages: English | deutsch

Authors

Moritz Herbst

¹Klinik für Unfall- und Wiederherstellungschirurgie, BG Unfallklinik Tübingen
Umito Kuwashima

²Joint Surgery Center, Yokosuka City Hospital, Yokosuka, Japan
Marc-Daniel Ahrend

¹Klinik für Unfall- und Wiederherstellungschirurgie, BG Unfallklinik Tübingen
Boyko Guergov Gueorguiev

³Biomedical Services, AO Research Institute Davos, Schweiz
Steffen Schröter

¹Klinik für Unfall- und Wiederherstellungschirurgie, BG Unfallklinik Tübingen
Christoph Ihle

¹Klinik für Unfall- und Wiederherstellungschirurgie, BG Unfallklinik Tübingen

Abstract

Background The subjective health related quality of life in patients with degenerative joint diseases is an important variable to evaluate the treatment outcome. In this study, mid-term results of open wedge HTO were analysed and compared to the subjective quality of life (SF 36) of the general population. Furthermore, the relationships of preoperative assessed subscales of the health-related quality of life (SF 36) and the conversion to knee arthroplasty were analysed.

Methods The cohort consisted of 120 patients who were prospectively followed-up after open wedge HTO. At five follow-up points of time, patients were examined and asked about their subjective, health-related quality of life using the SF 36 score.

Results 104 patients were included and evaluated until the last follow-up (mean: 81.2 ± 11.3 months after open wedge HTO; follow-up rate: 86.7%). Six years after open wedge HTO, similar values in several psychologic subscales of the SF 36 (BP, GH, V, MH) and the mental health component summary score (MCS) compared to the general population were found. The physical health component summary score (PCS) showed a significant improvement relative to the preoperative values. Nine out of 104 patients (8.7%) received a knee arthroplasty (50.1 ± 25.0 months). Low preoperative values of the subscales “physical functioning” (PF) and “bodily pain” (BP) were identified as risk factors in terms of conversion to a total knee arthroplasty.

Conclusions Patients with medial unicompartimental knee osteoarthrosis treated with open wedge HTO showed very good results. The health-related quality of life was nearly as high as in the general population. Patients with preoperative low physical function and high pain values have a higher risk to have a conversion to knee arthroplasty. Surgeons should be aware of these factors if an open wedge HTO is considered.

Key words

open wedge HTO - high tibial osteotomy - quality of life - SF 36 - knee osteoarthritis

Full Text

References

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