PMID- 38419060 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240301 IS - 2234-0726 (Print) IS - 2234-2451 (Electronic) IS - 2234-0726 (Linking) VI - 36 IP - 1 DP - 2024 Feb 28 TI - Clinical and radiological results of high tibial of osteotomy over the age of 65 are comparable to that of under 55 at minimum 2-year follow-up: a propensity score matched analysis. PG - 10 LID - 10.1186/s43019-024-00214-9 [doi] LID - 10 AB - PURPOSE: The results of medial open-wedge high tibial osteotomy (MOWHTO) according to age is inconclusive. This study aimed to compare the clinical outcomes and failure of MOWHTO in patients < 55 years and > 65 years. METHODS: Consecutive patients who underwent MOWHTO from July 2009 to August 2020 were retrospectively analyzed. 205 patients were considered for analysis. A 1-to-1 propensity score matched analysis to assess clinical outcomes scores including International Knee Documentation Committee (IKDC) subjective score and Lysholm score, radiologic outcomes, complication, and Total Knee Arthroplasty (TKA) conversion between patients > 65 years and patients < 55 years was performed. Radiologic outcomes included Hip-Knee-Ankle (HKA) angle, Weight Bearing Line ratio (WBLR), posterior tibial slope (PTS), and Insall-Salvati (IS) ratio before and after surgery. RESULTS: The follow-up period was 50.4 months in patients > 65 years and 55.3 months in patients < 55 years. There was no significant difference in the preoperative and postoperative HKA angle, WBLR, PTS, IS ratio, IKDC score and Lysholm score between the two groups. The arthroscopic evaluation of cartilage did not show any statistically significant differences between the two groups. Regarding Minimal clinically important differences (MCID), in the 26% of the older group exceeded MCID of IKDC score; 45% of the older group exceeded MCID of Lysholm score. In the younger group, 24% exceeded MCID of IKDC score and 35% exceeded MCID of Lysholm score. In older group, there were 7 (11.3%) cases of TKA conversion while no TKA conversion was recorded in the younger group. (P = 0.007) The average time to TKA conversion was 67 months. (42 months to 90 months) Kaplan-Meier analysis revealed that the survival rate was 95.2% at 4 years in the older group. CONCLUSION: Similar clinical results were obtained in patients over 65 years of age that were eligible for MOWHTO at minimum 2-year follow-up as in patients under 55 years of age. MOWHTO may be a viable option in older patients if proper indications are met. However, the risk of TKA conversion must be considered preoperatively and discussed with patients. STUDY DESIGN: Cohort study; Level of evidence, 3. CI - (c) 2024. The Author(s). FAU - Park, Jae-Young AU - Park JY AD - Department of Orthopaedic Surgery, CHA University, CHA Bundang Medical Center, 351 Yatap-Dong, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea. FAU - Kim, Jae-Hwa AU - Kim JH AD - Department of Orthopaedic Surgery, CHA University, CHA Bundang Medical Center, 351 Yatap-Dong, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea. FAU - Cho, Jin-Woo AU - Cho JW AD - Department of Orthopaedic Surgery, CHA University, CHA Bundang Medical Center, 351 Yatap-Dong, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea. FAU - Kim, Min Soo AU - Kim MS AD - Department of Orthopaedic Surgery, CHA University, CHA Bundang Medical Center, 351 Yatap-Dong, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea. FAU - Choi, Wonchul AU - Choi W AUID- ORCID: 0000-0002-4871-549X AD - Department of Orthopaedic Surgery, CHA University, CHA Bundang Medical Center, 351 Yatap-Dong, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea. wcosdoc@gmail.com. LA - eng GR - RS-2023-00210901/Ministry of Science, ICT and Future Planning/ GR - 2022R1G1A1011416/Ministry of Science and ICT, South Korea/ PT - Journal Article DEP - 20240228 PL - England TA - Knee Surg Relat Res JT - Knee surgery & related research JID - 101575761 PMC - PMC10900727 OTO - NOTNLM OT - Age OT - High tibial osteotomy OT - Osteoarthritis COIS- All authors indicate no conflicts of interest to report. EDAT- 2024/02/29 00:43 MHDA- 2024/02/29 00:44 PMCR- 2024/02/28 CRDT- 2024/02/28 23:48 PHST- 2023/08/01 00:00 [received] PHST- 2024/02/08 00:00 [accepted] PHST- 2024/02/29 00:44 [medline] PHST- 2024/02/29 00:43 [pubmed] PHST- 2024/02/28 23:48 [entrez] PHST- 2024/02/28 00:00 [pmc-release] AID - 10.1186/s43019-024-00214-9 [pii] AID - 214 [pii] AID - 10.1186/s43019-024-00214-9 [doi] PST - epublish SO - Knee Surg Relat Res. 2024 Feb 28;36(1):10. doi: 10.1186/s43019-024-00214-9.