HealthDay News — Most patients with osteoarthritis (OA) of the knee who undergo medial opening wedge high tibial osteotomy (HTO) do not undergo total knee replacement (TKR) within 10 years, according to a study published online Feb. 1 in CMAJ, the journal of the Canadian Medical Association.

Codie A. Primeau, from the Fowler Kennedy Sport Medicine Clinic in London, Ontario, Canada, and colleagues prospectively assessed patients with knee OA who underwent medial opening wedge HTO from 2002 to 2014 and examined the cumulative incidence of TKR in July 2019. The primary outcome of time to TKR was examined among 556 patients who underwent 643 HTO procedures.

The researchers found that the cumulative incidence of TKR was 5 and 21 percent at five and 10 years, respectively. Preoperative factors significantly associated with an increased rate of conversion were radiographic OA severity (adjusted hazard ratio, 1.96), pain (adjusted hazard ratio, 0.85), female sex (adjusted hazard ratio, 1.67), age (adjusted hazard ratio, 1.50 per 10 years), and body mass index (adjusted hazard ratio, 1.31 per 5 kg/m2).

“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,” a coauthor said in a statement.


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One author disclosed financial ties to the medical device industry.

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