HTO is a good option in the older patient: a single surgeon case series

Background:

The number of high tibial osteotomies (HTOs) are increasing year on year as documented in the United Kingdom Knee Osteotomy Registry (UKKOR). There is a paucity of evidence for their use in the older patient. Traditionally they are reserved for select, younger patients wishing to defer the need for total knee arthroplasty for a few more years. Approximately 70% of HTOs are performed on patients between 40 and 55 years of age.

Methods:

50 adult patients underwent consecutive HTOs for medial compartment osteoarthritis under the same Consultant Orthopaedic Surgeon at the Warrington & Halton NHS Hospital Trust from 2014 onwards. Validated Patient Reported Outcome Measure (PROM) scores were collected prospectively. Oxford and Knee Injury and Osteoarthritis Outcome Score (KOOS) scores were collected at 1 year, 2 year and up to 5 years. The cohort was divided into two groups based on age: group 1 were 53 years old or above. Those who were 52 or below were in group 2.

Results:

Both patient groups had comparable demographics and baseline PROMs scores. Group 1 had 27 patients with an age range between 53 and 71 years. Group 2 had 23 patients ranging from 26 to 52 years of age. There was no significant difference between the scores at either 1 year or 2 years (p<0.12, p<0.13).

Conclusion:

With good clinical acumen and appropriate patient selection HTO is a good option in the older patient with patients reporting just as good results in terms of pain, function, sport and quality of life as their younger counter parts.