Survival and Risk Factor Analysis of Medial Open Wedge High Tibial Osteotomy for Unicompartment Knee Osteoarthritis
Bibliographic record
Abstract
PURPOSE: The purpose of this retrospective study was to evaluate the survival rates and analyze the factors that affect survival rate after primary treatment with medial open wedge high tibial osteotomy (MOWHTO) for medial unicompartmental knee osteoarthritis. METHODS: Clinical evaluation using Knee Society Score (KSS) and Western Ontario and McMaster Universities Osteoarthritis Index score and radiographic evaluation, including mechanical axis, were done before and after surgery. The main failure criteria for survival included the conversion to total knee arthroplasty or KSS of <60 points. Furthermore, risk factors that affected the survival after MOWHTO were analyzed. RESULTS: Three hundred thirty-nine knees were included after a minimum of 5 years' follow-up. Their mean age was 56 years, and mean follow-up duration was 9.6 years. The mean KSS and Western Ontario and McMaster Universities Osteoarthritis Index scores were significantly improved after surgery (87.3 and 18.5 points at 5 years and 81.7 and 23.6 points at 10 years). The mean hip-knee-ankle (HKA) angle was corrected from 7.2° varus to 3.4° valgus 1 year after surgery, which was maintained until 10 years after surgery (2.9° valgus at 5 years and 2.3° valgus at 10 years, P > .05). Using Kaplan-Meier survival estimates, the probability of survival for MOWHTO was 96.8% at 5 years, 87.1% at 10 years, and 85.3% at 13 years. The multivariate regression analysis revealed that age ≥65 years (hazard ratio [HR] = 2.34, P = .046), medial compartment cartilage damage International Cartilage Repair Society grade ≥4 (HR = 2.46, I = .045), lateral compartment cartilage damage International Cartilage Repair Society grade≥2 (HR = 3.38, P = .006), postoperative HKA angle <0° (HR = 4.69, P < .001) were associated with failure. CONCLUSION: MOWHTO seems to be a good treatment option for young and active patients with medial knee osteoarthrosis and varus alignment, with acceptable survival rates and satisfactory outcomes. Age ≥65 years, grade 4 cartilage damage in medial compartment, grade ≥2 cartilage damage in lateral compartment, and undercorrection of HKA angle appear to be significant risk factors associated with failure. LEVEL OF EVIDENCE: Level IV: retrospective case series.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".