2017 ISAKOS Biennial Congress Paper #157
Does Subchondral Bone Marrow Edema Have Effect on Outcome of Medial Open Wedge High Tibial Osteotomy?
Wonchul Choi, MD, PhD, Sungnam-Si, Gyeonggi-Do KOREA, REPUBLIC OF
Banghyun Kim, MD, Bundang-Gu, Seongnam-Si, Gyeonggi-do KOREA, REPUBLIC OF
Uk Kim, MD, Seongnam-Si, Gyeonggi-do KOREA, REPUBLIC OF
Hyunsoo Ok, MD, Bundang-Gu, Seongnam-Si, Gyeonggi-do KOREA, REPUBLIC OF
Jae-Hwa Kim, PhD, Prof., Seung Nam, Kyenggi KOREA, REPUBLIC OF
Department of Orthopaedic Surgery, CHA University, Bundang CHA Medical Center, Sungnam-si, Gyeonggi-do, KOREA, REPUBLIC OF
FDA Status Cleared
The presence of preoperative subchondral bone marrow edema may have negative effect on postoperative pain and subjective outcome after medial open wedge high tibial osteotomy
The study purposed to compare outcomes of medial open wedge high tibial osteotomy (MOWHTO) patients with and without evidence of subchondral bone marrow edema (BME) in preoperative magnetic resonance imaging (MRI).
Materials And Methods
Sixty knees (60 patients) with MRI taken before undergoing MOWHTO for medial compartmental knee osteoarthritis and followed-up for average 23 months were included in this study. Knees were divided into 2 groups according to whether the evidence of proximal medial tibia or distal medial femur subchondral BME exists on MRI. Subchondral BME was found in 32 knees while no sign of BME was shown in 28 knees. We compared preoperative and postoperative pain visual analogue scale (VAS) and subjective International Knee Documentation Committee (IKDC) score between the groups. Differences in demographic (age, sex, body mass index and follow-up period) and radiographic (alignment, posterior tibia slope, patella height and degree of cartilage degeneration evaluated by the International Cartilage Repair Society grading system) parameters between the groups were also evaluated in order to find out any potential confounding factor.
Neither demographic nor preoperative and postoperative radiographic factors showed any inter-group differences. Preoperative pain VAS was significantly higher in knees with the sign of BME compared to the knees without BME (P = .022), while IKDC scores were similar between the groups (P = .220). Postoperatively, knees with BME showed significantly higher pain VAS (P = .018) and lower IKDC scores (P = .042).
Our result suggests that presence of preoperative subchondral bone marrow edema may have negative effect on postoperative pain and subjective outcome after medial open wedge high tibial osteotomy.