Postoperative improvement in patient-reported outcomes after neutral alignment medial open wedge high tibial osteotomy for medial compartment knee osteoarthritis in patients aged ≥70 years versus younger patients.

ABSTRACT

Purpose: To compare the postoperative clinical and radiological outcomes in patients aged ≥70 years following neutral alignment medial opening-wedge high tibial osteotomy (NA-MOWHTO) for medial compartment knee osteoarthritis (KOA) to those observed in younger patients. Methods: The data of patients who underwent NA-MOWHTO for medial compartment KOA between September 2018 and June 2022 were retrospectively analysed. The patients were categorised into groups Y (<70 years) and O (≥70 years). Age, sex, Kellgren-Lawrence classification, pre- and postoperative mechanical axis, weight-bearing line ratio, medial proximal tibial angle, preoperative Tegner Activity Score and pre- and postoperative Lysholm scores were compared between the groups. Results: Overall, 81 patients (60 and 21 in groups Y and O, respectively) who underwent NA-MOWHTO were included in this study. No significant differences were found in patient characteristics between the two groups, except for the preoperative Tegner Activity Score, which was significantly higher in group Y than in group O (3 [2-4] vs. 2 [2-2], respectively; p = 0.011). The two groups exhibited no significant differences in pre- and postoperative knee alignments. Postoperatively, Lysholm scores improved significantly in both groups without significant differences. Additionally, no correlation was found between age and pre- and postoperative Lysholm scores. Conclusions: The postoperative improvement following NA-MOWHTO for medial compartment KOA is comparable in patients aged ≥70 and younger. Level of Evidence Level III, Retrospective comparative study.