Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul 28;18(1):538.
doi: 10.1186/s13018-023-04041-8.

High tibial osteotomy improves balance control in patients with knee osteoarthritis and a varus deformity

Zheng Zhang  1 , Hai Tao  2 , Yingchun Zhao  2 , Wei Xiang  2 , Hui Cao  2 , Fenghua Tao  2
Affiliations

High tibial osteotomy improves balance control in patients with knee osteoarthritis and a varus deformity

Zheng Zhang et al. J Orthop Surg Res. .

Abstract

Background: Impaired knee stability is observed in patients with medial compartment knee osteoarthritis (OA) and varus malalignment. Although high tibial osteotomy (HTO) is widely used to treat OA-related knee varus deformity, its long-term influence on balance control in OA patients is poorly reported. This study aimed to evaluate the impact of HTO on balance control and assess its biological and functional significance.

Methods: Thirty-two patients with medial compartment knee OA as well as varus deformity who were scheduled for HTO underwent static posturographic tests one month pre- and three months as well as one year postoperatively, respectively, along with forty matched control subjects. Radiographic and clinical evaluations were synchronously carried out on patients pre- and postoperatively.

Results: Decreased postural sway was observed in patients one year after HTO. When compared to the control subjects, more postural sway was found in patients one month pre- and three months postoperatively. No difference was observed between the patients and control subjects one year postoperatively. The alignment and joint function of the affected knees significantly improved after HTO.

Conclusions: This study revealed that HTO improves balance control in patients with knee OA and varus deformity. Correct alignment and improved joint function enhance the likelihood of normal postural stability. Hence, this intervention allows the knee joint to recover its corrective compensatory role in postural regulation and should be taken into account for managing knee OA patients.

Keywords: Balance control; High tibial osteotomy; Knee varus; Osteoarthritis; Posturography.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Schematic diagram of the changes in postural sway area (in mm2) covered by the center of foot pressure (CoP) trajectory 1 month before, 3 and 12 months after HTO from left to right
Fig. 2
Fig. 2
Mean values with standard deviations of sway area for four conditions (C1-C4) and mean equilibrium score (MES) in patients 1 month before (white bars), 3 (light gray bars) and 12 months after HTO (dark gray bars); ***p < 0.001
Fig. 3
Fig. 3
Mean values with standard deviations of sway area for mean equilibrium score (MES) in patients (white bars) and control subjects (gray bars) 1 month before (A), 3 (B) and 12 months after HTO (C); ***p < 0.001
Fig. 4
Fig. 4
Mean values, associated with standard deviations, of clinical assessments of the affected knee joint observed in patients 1 month before HTO (white bars), 3 (light gray bars) and 12 months after HTO (dark gray bars); WOMAC: the Western Ontario and McMaster Universities osteoarthritis index; Lysholm: Lysholm knee score; VAS: visual analogue scale; ROM: range of motion; **p < 0.01, ***p < 0.001
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Allen KD, Thoma LM, Golightly YM. Epidemiology of osteoarthritis. Osteoarthritis Cartilage. 2022;30(2):184–195. doi: 10.1016/j.joca.2021.04.020. - DOI - PMC - PubMed
    1. Andriacchi TP, Koo S, Scanlan SF. Gait mechanics influence healthy cartilage morphology and osteoarthritis of the knee. J Bone Joint Surg Am. 2009;91(Suppl 1):95–101. doi: 10.2106/JBJS.H.01408. - DOI - PMC - PubMed
    1. Ogino T, Kumagai K, Yamada S, Akamatsu T, Nejima S, Sotozawa M, et al. Relationship between the bony correction angle and mechanical axis change and their differences between closed and open wedge high tibial osteotomy. BMC Musculoskelet Disord. 2020;21(1):675. doi: 10.1186/s12891-020-03703-6. - DOI - PMC - PubMed
    1. Wang X, Shi L, Zhang R, Wang W, Kong L, Zhao H, et al. Salvage of severe knee osteoarthritis: efficacy of tibial condylar valgus osteotomy versus open wedge high tibial osteotomy. J Orthop Surg Res. 2021;16(1):451. doi: 10.1186/s13018-021-02597-x. - DOI - PMC - PubMed
    1. Gauchard GC, Vancon G, Meyer P, Mainard D, Perrin PP. On the role of knee joint in balance control and postural strategies: effect of total knee replacement in elderly subjects with knee osteoarthritis. Gait Posture 2010;32(2):155–60. - PubMed

LinkOut - more resources