オカザキ　ケン   Okazaki Ken   岡崎　賢    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Effect of osteoarthritis severity on survival and clinical outcomes after high tibial osteotomy.
掲載誌名	正式名：The Knee 略　 称：Knee ISSNコード：18735800/09680160
掲載区分	国外
巻・号・頁	29,pp.441-447
著者・共著者	Kuwashima Umito, Iwasaki Kenyu, Kurakazu Ichiro, Akasaki Yukio, Nakashima Yasuharu, Itoh Masafumi, Itou Junya, Okazaki Ken
発行年月	2021/03
概要	BACKGROUND:This study aimed to evaluate the effect of osteoarthritis severity on clinical outcomes using the 2011 Knee Society Score (KSS2011) and survival rates after closed wedge high tibial osteotomy (CWHTO).METHODS:In this retrospective study, KSS2011 questionnaires were mailed to patients who had undergone CWHTO between January 1991 and December 2011. The completed questionnaires returned by the patients were analyzed. Preoperative osteoarthritis severity was evaluated by Kellgren-Lawrence (K-L) grade. KSS2011 was compared between the K-L grade groups. To determine the effect of K-L grade for revision surgery, Kaplan-Meier survival curves were created using the need for total knee arthroplasty (TKA) as the endpoint to estimate the probability of failure.RESULTS:There were 16, 81, and 47 knees with preoperative K-L 2, 3, and 4, respectively. Among the KSS2011 sub-scores, the symptom score showed significant differences between the groups (p = 0.006). However, no significant difference was found regarding satisfaction, expectation, and functional activity scores. No significant difference in the symptom score was found between the K-L 2 and 3 groups (p > 0.05). Eighteen knees were treated with TKA at a mean of 9 years after CWHTO. Using the Kaplan-Meier survival estimates, the K-L 4 group showed a significantly higher rate of total knee arthroplasty conversion than the K-L 2 and 3 groups (p < 0.001).CONCLUSIONS:Osteoarthritis severity affects clinical outcomes and survival rates during long-term follow-up after CWHTO. Surgeons should consider the preoperative osteoarthritis grade for long-term outcomes when considering CWHTO for patients with varus knees.
DOI	10.1016/j.knee.2021.02.031
PMID	33743259