Alternate type of surgery may prevent total knee replacement

Of the patients in this study getting high tibial osteotomy in London, Ontario (643 knees in 556 patients), 95% did not need a total knee replacement within 5 years, and 79% did not get a total knee replacement within 10 years. Even in patients traditionally not considered ideal candidates for high tibial osteotomy (e.g., women and patients with later-stage disease), about 70% did not get a knee replacement within 10 years.

The procedure is particularly suitable for people who are younger, have less severe joint damage and who may be more physically active. "Those patients especially contribute to the burden of knee osteoarthritis," says Mr. Codie Primeau, lead author. "There is a treatment gap between exhausting nonoperative treatments and appropriateness for joint replacement, resulting in many years of pain, lost productivity and associated costs."

"Given these findings, high tibial osteotomy may be underused in Canada and could be performed more often to delay or prevent the need for total knee replacement," says coauthor Dr. Robert Giffin, professor of surgery at Western University's Schulich School of Medicine & Dentistry and the Bone and Joint Institute.

"Total knee replacement after high tibial osteotomy: time-to-event analysis and predictors" is published February 1, 2021.