An underused type of knee surgery in younger patients, called high tibial osteotomy, shows considerable success in reduced need for total knee replacementaccording to new research published in the ‘Canadian Medical Association Journal’.
“The high tibial osteotomy is a knee surgery aimed at younger patients in the early stages of osteoarthritis of the knee. One of their goals is to prevent or delay the need for knee replacement,” explains co-author Dr. Trevor Birmingham, chair of Canada research in the School of Health Sciences and the Bone and Joint Institute at Western University. It’s like doing a front alignment on your car to stop asymmetric tire wear and increase tire longevity.”
Knee osteoarthritis is a common cause of pain and disability and places a huge burden on health systems. Total knee replacement is frequently performed in elderly patients with end-stage disease and limited mobility.
In Canada, total knee arthroplasty rates are high and increasing, while high tibial osteotomy rates are low and decreasing. One reason for this is the perception that high tibial osteotomy is not justified if the joint is to be replaced shortly thereafter. The findings of this new study contradict this perception.
Of the patients in this study who underwent a high tibial osteotomy in London, Ontario (643 knees in 556 patients), 95% did not need a total knee replacement in 5 years and 79% did not have a total knee replacement in 10 years. Even in patients not traditionally considered ideal candidates for high tibial osteotomy (eg, women and patients with advanced-stage disease), about 70% did not undergo knee replacement in 10 years.
The procedure is particularly suitable for people who are younger, who have less severe joint damage, and who They may be more physically active.
“These patients especially contribute to the burden of knee osteoarthritis,” explains Codie Primeau, lead author. a treatment gap between grueling non-surgical treatments and suitability for joint replacement, resulting in many years of pain, lost productivity and associated costs.”
“Based on these results, high tibial osteotomy may be underused in Canada and could be performed more frequently to delay or prevent the need for a total knee replacementsays co-author Dr. Robert Giffin, a professor of surgery at Western University Schulich School of Medicine and Dentistry and the Bone and Joint Institute.