TY - JOUR
T1 - High Tibial Osteotomy with a Modern Polyetheretherketone (PEEK) System
T2 - Mid-Term Results at a Mean of 6 Years Follow-Up
AU - Keyt, Lucas K.
AU - Hevesi, Mario
AU - Levy, Bruce A.
AU - Krych, Aaron J.
AU - Camp, Christopher L.
AU - Stuart, Michael J.
N1 - Publisher Copyright:
© 2022 Georg Thieme Verlag. All rights reserved.
PY - 2022/7/1
Y1 - 2022/7/1
N2 - The purpose of this study was to determine patient-reported outcomes, hardware removal rates, as well as conversion to arthroplasty at mid-term follow-up following high tibial osteotomy (HTO) with a modern polyetheretherketone (PEEK) system. All PEEK system-based HTOs performed at a single institution between January 2010 and January 2016 with a minimum of 2 years follow-up were reviewed. Rates of postoperative complications, hardware removal and conversion to arthroplasty were calculated. Patient-reported outcomes including visual analog pain scale (VAS), Tegner activity scale, Lysholm, Knee Injury and Osteoarthritis Outcome Score (KOOS), and 36-Item Short Form Survey (SF-36) were obtained. Forty-seven HTOs in 43 patients (mean age: 37.6 ± 10.8 years; 30 M, 13 F) were followed for a mean of 6.0 ± 1.5 years. A total of four postoperative complications occurred in three patients, resulting in an overall complication rate of 6.4%. Hardware removal occurred in three patients at a mean of 0.73 ± 0.53 years after surgery, with overall survival free of hardware removal of 96% (95% confidence interval [CI]: 85-99) at 1 year, 94% (95% CI: 82-98) at 2 years, and 94% (95% CI: 82-98) at 8 years. Conversion to arthroplasty occurred in three patients at a mean of 3.2 ± 1.0 years after surgery, with mean survival of 100% (95% CI: 94-100) at 1 year, 100% (95% CI: 94-100) at 2 years, and 93% (95% CI: 81-98) at 8 years. VAS at rest improved, from 3.1 ± 2.5 preoperatively to 1.1 ± 1.6 postoperatively (p < 0.001). Patients remained active, with a mean Tegner activity scale of 4.4 ± 1.4 at final follow-up and satisfactory Lysholm, KOOS, and SF-36 scores. At mid-term follow-up, medial opening-wedge HTO using a modern PEEK-based system was found to be safe, efficacious, and durable, with satisfactory outcome scores and a low rate of conversion to arthroplasty. PEEK-based implants were found to have low hardware removal rates of 6% at 5 years, which compares favorably to historic metal fixation. This is a Level III study.
AB - The purpose of this study was to determine patient-reported outcomes, hardware removal rates, as well as conversion to arthroplasty at mid-term follow-up following high tibial osteotomy (HTO) with a modern polyetheretherketone (PEEK) system. All PEEK system-based HTOs performed at a single institution between January 2010 and January 2016 with a minimum of 2 years follow-up were reviewed. Rates of postoperative complications, hardware removal and conversion to arthroplasty were calculated. Patient-reported outcomes including visual analog pain scale (VAS), Tegner activity scale, Lysholm, Knee Injury and Osteoarthritis Outcome Score (KOOS), and 36-Item Short Form Survey (SF-36) were obtained. Forty-seven HTOs in 43 patients (mean age: 37.6 ± 10.8 years; 30 M, 13 F) were followed for a mean of 6.0 ± 1.5 years. A total of four postoperative complications occurred in three patients, resulting in an overall complication rate of 6.4%. Hardware removal occurred in three patients at a mean of 0.73 ± 0.53 years after surgery, with overall survival free of hardware removal of 96% (95% confidence interval [CI]: 85-99) at 1 year, 94% (95% CI: 82-98) at 2 years, and 94% (95% CI: 82-98) at 8 years. Conversion to arthroplasty occurred in three patients at a mean of 3.2 ± 1.0 years after surgery, with mean survival of 100% (95% CI: 94-100) at 1 year, 100% (95% CI: 94-100) at 2 years, and 93% (95% CI: 81-98) at 8 years. VAS at rest improved, from 3.1 ± 2.5 preoperatively to 1.1 ± 1.6 postoperatively (p < 0.001). Patients remained active, with a mean Tegner activity scale of 4.4 ± 1.4 at final follow-up and satisfactory Lysholm, KOOS, and SF-36 scores. At mid-term follow-up, medial opening-wedge HTO using a modern PEEK-based system was found to be safe, efficacious, and durable, with satisfactory outcome scores and a low rate of conversion to arthroplasty. PEEK-based implants were found to have low hardware removal rates of 6% at 5 years, which compares favorably to historic metal fixation. This is a Level III study.
KW - KOOS
KW - SF-36 score
KW - Tegner activity score
KW - complication rate
KW - hardware removal rates
KW - high tibial osteotomy
KW - polyetheretherketone
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UR - http://www.scopus.com/inward/citedby.url?scp=85097079939&partnerID=8YFLogxK
U2 - 10.1055/s-0040-1721090
DO - 10.1055/s-0040-1721090
M3 - Article
C2 - 33231279
AN - SCOPUS:85097079939
SN - 1538-8506
VL - 35
SP - 916
EP - 921
JO - Journal of Knee Surgery
JF - Journal of Knee Surgery
IS - 8
ER -