Related Experiment Video
Updated: Jan 23, 2026
Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
Mild asymptomatic lateral osteoarthritis does not compromise outcomes after medial opening-wedge high tibial
Dries Van Leemput1, Jens Vanlommel1, Nathalie Van Beek1
1Department of Orthopedic Surgery, AZ Herentals, Herentals, Belgium.
Purpose:
High tibial osteotomy (HTO) is a reliable treatment for medial gonarthrosis in painful varus knees, relieving pain by redistributing load to the lateral compartment. Traditionally, lateral compartment osteoarthritis (OA) has been considered a contraindication. However, the recent ESSKA consensus suggests that mild lateral OA may not be an absolute contraindication, although supporting evidence remains limited. This retrospective study investigates the safety and efficacy of HTO in patients with mild-to-moderate asymptomatic lateral OA, hypothesising that HTO provides significant pain relief and functional improvement.
Methods:
A single-centre retrospective observational study was conducted on 132 patients who underwent HTO between 2017 and 2020 at AZ Herentals, Belgium. Inclusion criteria were completion of a 2-year postoperative questionnaire and preoperative magnetic resonance imaging (MRI) or single-photon emission computed tomography (SPECT-CT) within 1 year before surgery. The 'Knee Injury and Osteoarthritis Outcome Score-Physical Function Short Form' and 'Numeric Pain Rating Scale' were used. Lateral OA severity was assessed using radiographs, MRI and SPECT-CT. Outcomes were compared across different grades of lateral OA.
Results:
A total of 132 patients (95 men, 38 women; mean age 56 ± 8.7 years) were included. Patients with mild or moderate lateral OA signs on MRI showed significant improvement in pain and function up to 2 years. This was consistent with SPECT-CT and radiographic findings. No significant differences were observed between patients with different degrees of lateral OA. Linear regression revealed that larger osteophytes on MRI predicted more pain (β = 40.2, p = 0.0037) and worse function (β = 23.2, p = 0.049), while lower SPECT uptake predicted less pain (β = -16.9, p = 0.031).
Conclusion:
At 2 years post-HTO, pain and function did not differ significantly between patients with or without mild-to-moderate lateral gonarthrosis. Thus, mild asymptomatic lateral gonarthrosis should not be considered a contraindication for HTO. Longer-term studies are needed to confirm these findings.
Level Of Evidence:
Level III, retrospective comparative study.
More Related Videos
Related Concept Videos
01:24Wedges
Consider using a wedge to lift a heavy slab. Here, the wedge functions by converting the applied force into a much larger force directed almost perpendicular to the initial force. This...
02:24Predicting Reaction Outcomes
01:13Outcomes of Glycolysis
Cellular respiration can occur aerobically (with oxygen) or anaerobically (without oxygen). In the presence of oxygen, cellular respiration starts with glycolysis and continues with pyruvate...
01:28Lateralization
01:11Guidelines for Writing Outcome
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care...
01:27Cranial Bones: Lateral View
The temporal bone forms the lower lateral side of the skull. The temporal bone is subdivided into several regions. The flattened upper portion is the squamous portion of the temporal bone. Below this area and projecting anteriorly is the zygomatic process of the temporal bone, which forms the posterior portion of the zygomatic arch. Posteriorly is the mastoid portion of the temporal bone. Projecting...