The relationships between coronal plane alignments and patient-reported outcomes following high tibial osteotomy : a systematic review

Tawy, G; Shahbaz, H; McNicholas, M; Biant, LC

Abstract

Objective This systematic review aimed to determine whether coronal angular corrections correlate with patient reported outcomes following valgus-producing high tibial osteotomy (HTO). Design Ovid MEDLINE, Embase, and Web of Science were systematically searched. Studies that reported hip-knee-ankle angles (HKA) or femorotibial angles (FTA), and the Oxford Knee Score (OKS), visual analogue scale (VAS) score, Knee Injury and Osteoarthritis Outcome Score (KOOS), or EQ-5D before and after valgus-producing HTO were eligible. Correlation analyses were performed where appropriate to investigate the relationships between variables. PROSPERO ID: CRD42019135467. Results This study included 39 articles including 50 cohorts. VAS was reported in 22 studies, OKS in 9, KOOS in 12 and EQ-5D in 2. The HKA angle was corrected from 7.1° ± 1.7° varus to 2.3° ± 1.7° valgus at final follow-up. The FTA changed from 3.0° ± 2.0° varus to 7.7° ± 1.3° valgus. Outcome scores improved with clinical and statistical significance postoperatively. Spearman correlations for nonparametric data revealed greater changes in knee alignment were moderately associated with larger improvements in VAS scores ( r = 0.50). Furthermore, those who experienced greater changes in alignment showed larger improvements in the KOOS Activity and Quality of Life domains ( r = 0.72 and r = 0.51, respectively). Conclusion On average, patients did not achieve the “ideal correction” of 3° to 6° valgus postoperatively. Nevertheless, statistical and clinical improvements in patient-reported outcome measure scores were consistently reported. This suggests that the “ideal correction” may be more flexible than 3° to 6°.

Citation

Tawy, G., Shahbaz, H., McNicholas, M., & Biant, L. (2021). The relationships between coronal plane alignments and patient-reported outcomes following high tibial osteotomy : a systematic review. Cartilage, 13(1 sup.), 132S-146S. https://doi.org/10.1177/19476035211007903

• Journal Article Type: Article
• Online Publication Date: Apr 22, 2021
• Publication Date: Dec 1, 2021
• Deposit Date: May 4, 2021
• Publicly Available Date: May 4, 2021
• Journal: Cartilage
• Print ISSN: 1947-6035
• Electronic ISSN: 1947-6043
• Publisher: SAGE Publications
• Volume: 13
• Issue: 1 sup.
• Pages: 132S-146S
• DOI: https://doi.org/10.1177/19476035211007903
• Publisher URL: https://doi.org/10.1177/19476035211007903
• Related Public URLs: http://www.uk.sagepub.com/journals/Journal201953/
• Additional Information: Additional Information : ** From Crossref journal articles via Jisc Publications Router **Journal IDs: pissn 1947-6035; eissn 1947-6043 **History: issued 22-04-2021; published_online 22-04-2021