The primary objective of this prospective multicenter study is to assess whether the functional outcome measured with the Knee Injury and Osteoarthritis Outcome Score (KOOS) for patients with medial unicompartmental osteoarthritis and osteonecrosis of the knee treated with open wedge high tibial osteotomy (HTO) using the TomoFix™ Small is better than the functional outcome after conservative treatment.
Osteoarthritis (OA) of the knee (gonarthrosis) is a common medical condition and causes pain and disability. By 65 years of age, the majority of the US population has radiographic evidence of OA and 11% have symptomatic OA of the knee. In Japan, OA of the knee is more common due to the common sitting style with maximally flexed knees and parallel position of both legs. High Tibial Osteotomy (HTO) for knee OA is a standard procedure in orthopedic surgery. Six years ago, HTO using TomoFix™ was introduced. Because Asian people have different geometric dimensions of the tibiae, an adaptation of size and shape was necessary, and the new TomoFix™ Small was developed. Although there is widespread literature concerning osteotomy for treating knee OA, literature assessing patient outcome after open wedge HTO using TomoFix™ is rare and for TomoFix™ Small, this data is still nonexistent. Therefore, the primary aim of the present multicenter study is to evaluate patient functional outcome using the KOOS. Since a proportion of patients with the indication for HTO refuse surgery and opt to receive conservative treatment, the functional results of patients treated with HTO using TomoFix™ Small will be compared with these patients.
Study Type
OBSERVATIONAL
Enrollment
148
Toyama Municipal Hospital
Toyama, Japan
Knee Injury and Osteoarthritis Outcome Score (KOOS)
Time frame: 1 month, 3 months, 6 months, 12 months, 24 months, 3 years, 4 years, and 5 years
Patient-evaluated function of the knee and quality of life, a. assessed with the Oxford-12-item knee score b. assessed with the WOMAC (as calculated from the KOOS)
Time frame: 1 month, 3 months, 6 months, 12 months, 24 months, 3 years, 4 years, and 5 years
Clinician-evaluated function of the knee, assessed with the Japanese Orthopaedic Association (JOA) score
Time frame: 1 month, 3 months, 6 months, 12 months, 24 months, 3 years, 4 years, and 5 years
Health-related quality of life assessed by the generic Short Form-36 (SF-36) instrument
Time frame: 1 month, 3 months, 6 months, 12 months, 24 months, 3 years, 4 years, and 5 years
Range of motion (ROM)
Time frame: 1 month, 3 months, 6 months, 12 months, 24 months, 3 years, 4 years, and 5 years
Local and general pain, assessed with the Visual Analogue Scale (VAS)
Time frame: 1 month, 3 months, 6 months, 12 months, 24 months, 3 years, 4 years, and 5 years
Possibility and duration of the Japanese sitting style
Time frame: 3 months, 6 months, 12 months, 24 months, 3 years, 4 years, and 5 years
Surgery details, Postoperative treatment, Postoperative rehabilitation, Utilization
Time frame: postoperative period
Evaluation of degenerated and regenerated cartilage (arthroscopic findings assessed according to ICRS and Outerbridge / Koshino)
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Time frame: intraoperative and after 2 years
Radiological parameters (e.g. union, delayed union, Kellgren-Lawrence classification, joint space narrowing, tibial slope, tibia vara, patella height according to Blackburne-Peel, modified Insall-Salvati ratio, subluxation of patella)
Time frame: 1 month, 3 months, 6 months, 12 months, 24 months, 3 years, 4 years, and 5 years
Complications and mortality
Time frame: 1 month, 3 months, 6 months, 12 months, 24 months, 3 years, 4 years, and 5 years