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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 3/2017

01-03-2017 | Knee

Health-related quality of life after open-wedge high tibial osteotomy

Authors: Tim Saier, Philipp Minzlaff, Matthias J. Feucht, Lena Lämmle, Maike Burghoff, Christoph Ihle, Andreas B. Imhoff, Stefan Hinterwimmer

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 3/2017

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Abstract

Purpose

(1) To monitor longitudinal changes in health-related quality of life (HRQOL), pain, knee function, and return to work (RtW) following high tibial osteotomy (HTO) for medial compartment osteoarthritis (OA), and (2) to investigate the influences of psychopathological comorbidities on preoperative impairment and post-operative course.

Methods

Sixty-four patients were prospectively followed for 24 months after HTO to determine HRQOL, pain, functional outcome, and RtW. Psychopathological comorbidities (e.g. depression) were determined preoperatively. Patients with no psychological distress (ND) were compared to patients with psychological distress (PD) in order to investigate the influence of psychopathological comorbidities on outcome.

Results

There was a significant increase in HRQOL and decrease in pain from 6 month follow-up on. Functional outcomes increased significantly from 12 month follow-up on. In general, there was a steady state of outcomes from 6- to 12-month follow-up on. At final follow-up, 90 % returned to their previous occupation without limitations. Mental component summary (MCS) and functional outcome showed a positive correlation with RtW, while depression had a negative one. A significantly inferior outcome of group PD versus ND was observed at baseline and early follow-up. RtW was significantly prolonged in group PD (8.9 ± 7.6 vs. 3.9 ± 3 months; p < 0.001). At final follow-up, both groups presented with comparable outcomes.

Conclusion

HTO for medial compartment OA significantly improves HRQOL, pain, and knee function. Time to RtW is high and critically depends on PD. Further, extend of preoperative impairments, an initially inferior course, and inferior MCS outcome was influenced by PD. However, otherwise no significant differences were observed between groups PD and ND at final follow-up.

Level of evidence

Prospective case series, II.
Appendix
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Metadata
Title
Health-related quality of life after open-wedge high tibial osteotomy
Authors
Tim Saier
Philipp Minzlaff
Matthias J. Feucht
Lena Lämmle
Maike Burghoff
Christoph Ihle
Andreas B. Imhoff
Stefan Hinterwimmer
Publication date
01-03-2017
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 3/2017
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-015-3938-4

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