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High tibial osteotomy in Sweden, 1998-2007: a population-based study of the use and rate of revision to knee arthroplasty.

W-Dahl A, Robertsson O, Lohmander LS - Acta Orthop (2012)

Bottom Line: The number of HTOs decreased by one third between 1998 and 2007, from 388 operations a year to 257 a year.The cumulative revision rate at 10 years was 30% (95% CI: 28-32).The risk of revision increased with increasing age and was higher in women than in men (RR = 1.3, CI: 1.1-1.5).

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Clinical Sciences Lund, Lund University, Lund, Sweden. annette.w-dahl@med.lu.se

ABSTRACT

Background and purpose: Most studies on high tibial osteotomies (HTOs) have been hospital-based and have included a limited number of patients. We evaluated the use and outcome-expressed as rate of revision to knee arthroplasty-of HTO performed in Sweden with 9 million inhabitants, 1998-2007.

Patients and methods: 3, 161 HTO procedures on patients 30 years or older (69% men) who were operated on for knee osteoarthritis in Sweden, 1998-2007, were identified through the inpatient and outpatient care registers of the Swedish National Board of Health and Welfare. Pertinent data were verified through surgical records. Conversions of HTO to knee arthroplasty before 2010 were identified through the Swedish Knee Arthroplasty Register (SKAR). The 10-year survival was determined using revision to an arthroplasty as the endpoint.

Results: The number of HTOs decreased by one third between 1998 and 2007, from 388 operations a year to 257 a year. Most of the HTOs were performed with open wedge osteotomy using external fixation. The cumulative revision rate at 10 years was 30% (95% CI: 28-32). The risk of revision increased with increasing age and was higher in women than in men (RR = 1.3, CI: 1.1-1.5).

Interpretation: If being without an artificial joint implant is considered to be beneficial, then HTO is an excellent alternative to knee arthroplasty in younger and/or physically active patients suffering from knee osteoarthritis.

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Cumulative revision rate (CRR) of HTO, with follow-up to 2010.
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Figure 4: Cumulative revision rate (CRR) of HTO, with follow-up to 2010.

Mentions: The 10-year risk of an HTO being converted to an arthroplasty was 30% (CI: 28–32) and the 13-year risk was 37% (CI: 34–57) (Figure 4). 730 HTOs were later converted to an arthroplasty. 6 additional cases were considered to be conversions, in a worst-case scenario whereby the HTO side was unknown and the patient had undergone a later knee arthroplasty.


High tibial osteotomy in Sweden, 1998-2007: a population-based study of the use and rate of revision to knee arthroplasty.

W-Dahl A, Robertsson O, Lohmander LS - Acta Orthop (2012)

Cumulative revision rate (CRR) of HTO, with follow-up to 2010.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3369149&req=5

Figure 4: Cumulative revision rate (CRR) of HTO, with follow-up to 2010.
Mentions: The 10-year risk of an HTO being converted to an arthroplasty was 30% (CI: 28–32) and the 13-year risk was 37% (CI: 34–57) (Figure 4). 730 HTOs were later converted to an arthroplasty. 6 additional cases were considered to be conversions, in a worst-case scenario whereby the HTO side was unknown and the patient had undergone a later knee arthroplasty.

Bottom Line: The number of HTOs decreased by one third between 1998 and 2007, from 388 operations a year to 257 a year.The cumulative revision rate at 10 years was 30% (95% CI: 28-32).The risk of revision increased with increasing age and was higher in women than in men (RR = 1.3, CI: 1.1-1.5).

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Clinical Sciences Lund, Lund University, Lund, Sweden. annette.w-dahl@med.lu.se

ABSTRACT

Background and purpose: Most studies on high tibial osteotomies (HTOs) have been hospital-based and have included a limited number of patients. We evaluated the use and outcome-expressed as rate of revision to knee arthroplasty-of HTO performed in Sweden with 9 million inhabitants, 1998-2007.

Patients and methods: 3, 161 HTO procedures on patients 30 years or older (69% men) who were operated on for knee osteoarthritis in Sweden, 1998-2007, were identified through the inpatient and outpatient care registers of the Swedish National Board of Health and Welfare. Pertinent data were verified through surgical records. Conversions of HTO to knee arthroplasty before 2010 were identified through the Swedish Knee Arthroplasty Register (SKAR). The 10-year survival was determined using revision to an arthroplasty as the endpoint.

Results: The number of HTOs decreased by one third between 1998 and 2007, from 388 operations a year to 257 a year. Most of the HTOs were performed with open wedge osteotomy using external fixation. The cumulative revision rate at 10 years was 30% (95% CI: 28-32). The risk of revision increased with increasing age and was higher in women than in men (RR = 1.3, CI: 1.1-1.5).

Interpretation: If being without an artificial joint implant is considered to be beneficial, then HTO is an excellent alternative to knee arthroplasty in younger and/or physically active patients suffering from knee osteoarthritis.

Show MeSH
Related in: MedlinePlus