2023, Vol. 27 ›› Issue (9): 1325-1329

Changes of lower limb force line and knee function after high tibial osteotomy in osteoporotic medial ventricular knee osteoarthritis

Li Xiaomin1, Tian Xiangdong2, Tan Yetong2, Zhu Guangyu2, Wang Rongtian2, Wang Jian2, Xue Zhipeng2, Ma Sheng2, Hu Yuanyi2, Huang Ye1, Ding Tiansong1   

Abstract: BACKGROUND: Elderly patients with knee osteoarthritis are mostly accompanied by osteoporosis. There is still a lack of relevant clinical studies on whether osteoporosis will affect the postoperative efficacy of high tibial osteotomy for medial compartment knee osteoarthritis.  
OBJECTIVE: To explore the effect of osteoporosis on the clinical efficacy of medial compartment knee osteoarthritis after high tibial osteotomy from the aspects of imaging and knee joint function.
METHODS: A retrospective analysis was performed in 63 patients with medial compartment knee osteoarthritis who received high tibial osteotomy combined with arthroscopy in Third Affiliated Hospital of Beijing University of Chinese Medicine from January 2018 to January 2019. According to the results of bone mineral density measurement, there were 30 patients in the osteoporosis group (mean T value was   -2.9 SD). There were 33 patients in the control group (non-osteoporosis, mean T value was -0.9 SD). The knee joint pain was evaluated by visual analogue scale score before and 3, 12, and 24 months after operation. Knee function was evaluated by Western Ontario and McMaster University Osteoarthritis Index and Lysholm knee score. The ratio of lower limb force line was used to evaluate the change of lower limb force line before, after intraoperative correction and 24 months after surgery.
RESULTS AND CONCLUSION: (1) All patients completed surgery and were followed up. (2) Visual analogue scale score, Western Ontario and McMaster University Osteoarthritis Index and Lysholm knee score in both groups improved over time after surgery compared with that before surgery (P < 0.05). The ratio of lower limb force line in both groups improved after intraoperative correction and 24 months after operation compared with that before operation (P < 0.05). (3) There was no difference in visual analogue scale scores, Western Ontario and McMaster University Osteoarthritis Index and Lysholm knee score between the two groups 3, 12 and 24 months after surgery (P > 0.05). (4) There was no significant difference in the ratio of lower limb force line between the two groups before surgery, after intraoperative correction and 24 months after surgery (P > 0.05). (5) It is indicated that in the early and middle stages of high tibial osteotomy, osteoporosis has no significant effect on the postoperative efficacy and lower limb force line. In conclusion, high tibial osteotomy has a definite curative effect in the early and middle stages of osteoporotic medial compartment knee osteoarthritis, which can significantly relieve knee pain and improve knee function, and is a good choice for the treatment of osteoporotic medial compartment knee osteoarthritis. However, more studies are needed to confirm whether osteoporosis will affect the long-term outcome after high tibial osteotomy.
Key words: osteoporosis, knee osteoarthritis, high tibial osteotomy, arthroscopy, lower limb force line