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Huang T, Kang K, Qiao Q, Li T, Liu T, Ji C, Gao S. Muti-factor analysis of sport activity level after high tibial osteotomy. J Orthop Surg Res 2023; 18:813. [PMID: 37907953 PMCID: PMC10617058 DOI: 10.1186/s13018-023-04305-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 10/20/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Although many studies have shown that high tibial osteotomy is appropriate for active patients, there are limited multifactorial studies on patients' sport activity level after HTO in general population. METHODS 158 patients who underwent HTO for knee osteoarthritis between January 2016 and December 2019 are included, with a 36-month follow-up. Information was collected from X-rays and questionnaire. The independent variables were age, sex, breadwinner (provide more than 50% income), sport activity level when the knee was pain-free before and after surgery, concomitant meniscal treatment history, Lysholm knee score, desire level for returning to sports. The 158 cases are divided into three groups according to their sports participation before and after operation, Chi-square tests and ANOVA analysis were adopted to identify the effect of these variables on sport activity level after HTO, and factors with statistical differences and clinical relevancies, or provided by previous research were assessed with the ordinal logistic regression analysis. RESULTS According to sport activity level analysis, 28(17.7%) patients were categorized into the sport level-reduced group, 97(61.4%) patients into the sport level-unchanged group, and 33(20.9%) patients into the sport level-improved group. Upon ordinal logistic regression analysis, postoperative MA%, age, BMI, and preoperative Lysholm knee score were statistically significant. CONCLUSIONS Higher postoperative MA%, younger age, lower BMI, and lower Lysholm score are associate with improvement on activity level after HTO. This finding provides valuable references in operation option and rehabilitation planning.
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Affiliation(s)
- Teng Huang
- Department of Orthopedic Surgery, Hebei Medical University Third Hospital, Shijiazhuang, Hebei, China
- Department of Orthopedic Surgery, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Kai Kang
- Department of Orthopedic Surgery, Hebei Medical University Third Hospital, Shijiazhuang, Hebei, China
| | - Qi Qiao
- Department of Orthopedic Surgery, Hebei Medical University Third Hospital, Shijiazhuang, Hebei, China
| | - Tong Li
- Department of Orthopedic Surgery, Hebei Medical University Third Hospital, Shijiazhuang, Hebei, China
| | - Tao Liu
- Department of Orthopedic Surgery, Hebei Medical University Third Hospital, Shijiazhuang, Hebei, China
| | - Chenni Ji
- Department of Orthopedic Surgery, Hebei Medical University Third Hospital, Shijiazhuang, Hebei, China
| | - Shijun Gao
- Department of Orthopedic Surgery, Hebei Medical University Third Hospital, Shijiazhuang, Hebei, China.
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Li J, Zhao F, Dong W, Yu X, Zhu C, Liu S, Jia G, Liu G. Medial open-wedge high tibial osteotomy for the treatment of degenerative varus knee osteoarthritis in geriatric patients: a retrospective study. Sci Rep 2023; 13:16848. [PMID: 37803059 PMCID: PMC10558429 DOI: 10.1038/s41598-023-44051-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 10/03/2023] [Indexed: 10/08/2023] Open
Abstract
HTO has proven to be a cost-effective surgical procedure in the treatment of KOA, but few investigations have studied radiological changes and clinical effectiveness of OWHTO in geriatric patients. 76 patients were recruited in this retrospective study. According to the age, patients were divided into two groups (≤ 60, Group "Young"; > 60, Group "Geriatric"). Demographic data, radiological imaging and postoperative complications were analyzed. Kellgren-Lawrence grade (K-L), weight-bearing line ratio (WBLR); posterior tibial slope angle (PTS); American knee score (AKS); Western Ontario and McMaster Universities Arthritis Index (WOMAC) and visual analog scale (VAS) were introduced to estimate the clinical outcome of OWHTO. There were 18 male and 58 female patients in the present study with a mean age of 58.5 ± 9.2 years (ranges from 40 to 82 years); the average age was 51.4 ± 4.1 years and 67.3 ± 4.9 years for group Y and G respectively, 44.7% and 31.5% patients were older than 60 and 65 years. BMI for the 76 patients was 26.6 ± 3.2 kg/m2, and geriatric patients were more likely accompanied by one or more comorbidities (70.6 vs. 45.2%). There were 34 and 42 patients in group Geriatric and group Young respectively, and no significant difference of MPTA, WBLR, PTS and WOMAC, VAS, AKS and ROM between the two group (P > 0.05) were found. After more than a two-year follow-up period, postoperative WBLR, AKS, WOMAC and VAS were much more desired than preoperative, and no significant difference of these variables between the young and geriatric group (P > 0.05), however, elderly patients were more likely to suffer from a longer bone union time. OWHTO can avoid geriatric patients from undergoing secondary knee surgery in the short term, however the survival rate of OWHTO in geriatric patients should be ultimately clarified by different studies.
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Affiliation(s)
- Jia Li
- Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang, 050031, Hebei, People's Republic of China
| | - Feng Zhao
- Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang, 050031, Hebei, People's Republic of China
| | - Wei Dong
- Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang, 050031, Hebei, People's Republic of China
| | - Xiaoguang Yu
- Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang, 050031, Hebei, People's Republic of China
| | - Chaohua Zhu
- Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang, 050031, Hebei, People's Republic of China
| | - Sen Liu
- Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang, 050031, Hebei, People's Republic of China
| | - Guoxing Jia
- Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang, 050031, Hebei, People's Republic of China
| | - Guobin Liu
- Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang, 050031, Hebei, People's Republic of China.
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Katagiri H, Nakagawa Y, Amano Y, Shirakawa Y, Ozeki N, Nakamura T, Sekiya I, Koga H. Decision regret following opening wedge high tibial osteotomy: Older age as a risk factor. Knee 2023; 43:62-69. [PMID: 37271073 DOI: 10.1016/j.knee.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 02/09/2023] [Accepted: 05/11/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Understanding risk factors that can predict decision regret after surgical procedures can potentially increase the quality of patient decision making and reduce decision regret after opening wedge high tibial osteotomy (OWHTO). The purpose of the present study was to identify the risk factors that predict the likelihood of decision regret after OWHTO. METHOD Questionnaires were administered to 98 eligible OWHTO recipients more than one year post-operatively. They answered "Yes" or "No" to the question "Would you go for the same choice (OWHTO) if you had to do it over again?" Univariate and multivariate logistic regression analyses were conducted using the decision regret questionnaire as the dependent variable against patient characteristics and surgery related factors. A receiver operating characteristic curve and area under the curve were constructed and calculated for age at surgery. Cut-off values were determined using the Youden principle and receiver operating characteristic curves. RESULTS Among the 98 respondents, 18 (18%) reported regretting their decision. Older age at surgery was the only predictive risk factor for decision regret (P < 0.01). The area under the curve for the model using age to predict failure was 0.722. The cut-off value was 71 years. Patients aged 71 years or more had a 7.841 odds ratio for decision regret (P < 0.01). CONCLUSIONS Older age emerged as a predictive risk factor for decision regret after OWHTO. Patients aged 71 years or older had a higher decision regret rate after OWHTO than younger patients and should more carefully weigh the suitability of OWHTO against other options.
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Affiliation(s)
- Hiroki Katagiri
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Japan; Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center, Japan
| | - Yusuke Nakagawa
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Japan; Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine (TMDU), Japan
| | - Yusuke Amano
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Japan; Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine (TMDU), Japan
| | - Yoshiko Shirakawa
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Japan; Department of Orthopaedic Surgery, Medical Corporation Jinseikai Takagi Hospital, Japan
| | - Nobutake Ozeki
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine (TMDU), Japan; Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University (TMDU), Japan
| | - Tomomasa Nakamura
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Japan; Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine (TMDU), Japan
| | - Ichiro Sekiya
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine (TMDU), Japan; Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University (TMDU), Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Japan; Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine (TMDU), Japan.
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Jiang H, Xie W, Li X, Wang H, Yu WJ, Chen X. The survival benefit from surgery on patients with large-cell neuroendocrine carcinoma in the lung: a propensity-score matching study. J Cardiothorac Surg 2023; 18:216. [PMID: 37408065 DOI: 10.1186/s13019-023-02314-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 06/28/2023] [Indexed: 07/07/2023] Open
Abstract
PURPOSE This study aimed to investigate the prognostic significance of surgery in large-cell neuroendocrine carcinoma (LCNC) patients. METHODS A total of 453 patients from the Surveillance, Epidemiology, and End Results database diagnosed with stage T1-4N0-2M0 LCNC from 2010 to 2015 were analyzed. The propensity-score matching analysis with a ratio of 1:1 was used to minimize the bias effect of other clinical characteristics, and 77 pairs of patients' data were performed for subsequent statistical analysis. The Cox proportional hazards model, Kaplan-Meier analysis, and Log-rank test were used in the present study. The primary observational endpoint was cancer-specific survival (CSS). RESULTS The 1-year, 3-year, and 5-year CSS rates were 60.0%, 45.0%, and 42.0% in those 453 LCNC patients. Compared with patients who underwent surgical resection, patients without surgery had a lower 5-year CSS rate (18.0% vs. 52.0%, P < 0.001). After analyses of multivariable Cox regression, chemotherapy, T stage, N stage, and surgery were identified as independent prognostic indicators (all P < 0.05). In the cohort of old patients, the median survival time was longer in cases after surgery than those without surgery (13.0 months vs. NA, P < 0.001). Besides, in patients with different clinical characteristics, the receiving surgery was a protective prognostic factor (all hazard ratio < 1, all P < 0.05). In addition, for the cohort with stage T1-2N0-2M0, patients after the operation had more improved outcomes than patients without surgery (P < 0.001). CONCLUSIONS We proposed that the surgery could improve the survival outcomes of LCNC patients with stage T1-4N0-2M0. Moreover, old patients could benefit from surgery.
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Affiliation(s)
- Hao Jiang
- Infectious Department, The Affiliated People's Hospital of Ningbo University, Yinzhou People's Hospital, Ningbo, 315040, P. R. China.
| | - Weixia Xie
- Hematological Department, The Affiliated People's Hospital of Ningbo University, Yinzhou People's Hospital, Ningbo, 315040, P. R. China
| | - Xianpeng Li
- Infectious Department, The Affiliated People's Hospital of Ningbo University, Yinzhou People's Hospital, Ningbo, 315040, P. R. China
| | - Huaying Wang
- Department of Respiratory and Critical Care, Yinzhou People's Hospital, The Affiliated People's Hospital of Ningbo University, Ningbo, 315040, P. R. China
| | - Wan-Jun Yu
- Department of Respiratory and Critical Care, Yinzhou People's Hospital, The Affiliated People's Hospital of Ningbo University, Ningbo, 315040, P. R. China
| | - Xiaolu Chen
- Department of Respiratory and Critical Care, Yinzhou People's Hospital, The Affiliated People's Hospital of Ningbo University, Ningbo, 315040, P. R. China
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Sakai M, Akasaki Y, Akiyama T, Horikawa T, Okazaki K, Hamai S, Tsushima H, Kawahara S, Kurakazu I, Kubota K, Mizu-Uchi H, Nakashima Y. Similar short-term KOOS between open-wedge high tibial osteotomy and total knee arthroplasty in patients over age 60: A propensity score-matched cohort study. Mod Rheumatol 2023; 33:623-628. [PMID: 35652607 DOI: 10.1093/mr/roac052] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 04/28/2022] [Accepted: 05/28/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The purpose of the present study was to evaluate improvement in the Knee Injury and Osteoarthritis Outcome Score (KOOS) after open-wedge high tibial osteotomy (HTO) in comparison with total knee arthroplasty (TKA) in cohorts over age 60 matched by pre-operative age, gender, body mass index (BMI), hip-knee-ankle angle (HKAA), KOOS sub-scores, and osteoarthritis (OA) grade. METHODS Propensity score matching was performed between 162 HTO patients and 134 TKA patients. When calculating the propensity score by multivariate logistic regression analysis, the following pre-operative confounders were included: age, gender, BMI, HKAA, KOOS sub-scores, and OA grade. Consequently, a total of 55 patients were included in each group. The Student's t-test was used to analyse differences in the post-operative KOOS sub-scores between groups. RESULTS After propensity score matching, all matched pre-operative valuables were identical, with no significant differences between the HTO and TKA groups. None of the post-operative KOOS sub-scores at 1 year after surgery showed a significant difference between the HTO and TKA groups. Both groups demonstrated significant and comparable post-operative improvement in every KOOS sub-score. CONCLUSIONS In patients over age 60, there was no significant difference in short-term pain relief and improvements in activity and quality of life between HTO and TKA after propensity score matching including pre-operative age, KOOS sub-scores, and OA grade. HTO is a joint preservation procedure that is valid for knee OA even in individuals over age 60.
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Affiliation(s)
- Mamiko Sakai
- Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan
| | - Yukio Akasaki
- Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan
| | | | - Tomohiro Horikawa
- Department of Orthopaedic Surgery, Omuta Tenryo Hospital, Omuta, Japan
- Department of Orthopaedic Surgery, National Hospital Organization Kumamoto Saishun Medical Center, Koshi, Kumamoto, Japan
| | - Ken Okazaki
- Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Satoshi Hamai
- Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan
| | | | - Shinya Kawahara
- Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan
| | - Ichiro Kurakazu
- Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan
| | - Kenji Kubota
- Department of Orthopaedic Surgery, Omuta Tenryo Hospital, Omuta, Japan
| | - Hideki Mizu-Uchi
- Department of Orthopaedic Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
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