Background: Osteoarthritis is a pathological condition that affects movable joints, marked by cellular stress and the breakdown of the extracellular matrix. It is triggered by both micro and macro injuries, which initiate maladaptive repair mechanisms, including pro-inflammatory pathways associated with innate immunity. The disease initially presents as a molecular disturbance, involving abnormal metabolism of joint tissue. This is subsequently followed by anatomical and/or physiological disruptions, marked by cartilage breakdown, bone remodeling, osteophyte development, joint inflammation, and impaired joint function. These progressive changes can ultimately lead to illness. As of 2010, around 250 million people worldwide, or 3.6% of the population, were affected by knee osteoarthritis. Hip osteoarthritis, on the other hand, impacted approximately 0.85% of the global population. Both conditions held the 11th position among 291 disease-related causes of disability assessed globally. In the United States alone, there were roughly 964,000 hospitalizations due to osteoarthritis in 2011, equating to a rate of 31 stays per 10,000 individuals. These hospitalizations incurred a total cost of $14.8 billion, with an average expense of $15,400 per stay. This made osteoarthritis the second most expensive condition treated in U.S. hospitals that year. When categorized by payer, it was also the second-costliest condition billed to both private insurance and Medicare. Objectives: Our approach emphasizes preserving the knee joint and postponing knee arthroplasty in older individuals. The objective of our work is to demonstrate the effectiveness of simultaneously performing high tibial osteotomy (HTO) and arthroscopic chondroplasty in patients with medial compartment osteoarthritis of the knee. The correction of varus deformity in knee osteoarthritis is guided by the patient’s knee morphology, range of motion (ROM), findings from X-rays and MRI, as well as the patient’s symptoms, their duration, expectations, and recovery time. Methods: Patients presenting with knee joint osteoarthritis have been systematically evaluated through a detailed collection of medical history (anamnesis), clinical examinations of both the knee and hip joints. Preoperative instrumental diagnostic procedures involve standard anteroposterior (AP, standing position) and lateral-medial (LM) radiographic imaging of the knee joint, a topographic scan of the entire lower extremities, and magnetic resonance imaging (MRI) of the knee joint.
References
[1]
Devaraj, T.L. (2011) Nature Cure Yoga for Osteoarthritis. Nature Cure for Common Diseases. Arya Publication, 368 p.
[2]
Tanchev, P. (2017) Osteoarthritis or Osteoarthrosis: Commentary on Misuse of Terms. Reconstructive Review, 7, 178-178. https://doi.org/10.15438/rr.7.1.178
[3]
Kraus, V.B., Blanco, F.J., Englund, M., Karsdal, M.A. and Lohmander, L.S. (2015) Call for Standardized Definitions of Osteoarthritis and Risk Stratification for Clinical Trials and Clinical Use. Osteoarthritis and Cartilage, 23, 1233-1241. https://doi.org/10.1016/j.joca.2015.03.036
[4]
Cross, M., Smith, E., Hoy, D., Nolte, S., Ackerman, I., Fransen, M., et al. (2014) The Global Burden of Hip and Knee Osteoarthritis: Estimates from the Global Burden of Disease 2010 Study. Annals of the Rheumatic Diseases, 73, 1323-1330. https://doi.org/10.1136/annrheumdis-2013-204763
[5]
Pfuntner, A., Wier, L.M. and Stocks, C. (2016) Most Frequent Conditions in U.S. Hospitals, 2011. HCUP Statistical Brief #162.
[6]
Torio, C.M. and Andrews, R.M. (2013) National Inpatient Hospital Costs: The Most Expensive Conditions by Payer, 2011. HCUP Statistical Brief #160. Agency for Healthcare Research and Quality.
[7]
Pfuntner, A., Wier, L.M. and Steiner, C. (2013) Costs for Hospital Stays in the United States, 2011. Statistical Brief #168. Agency for Healthcare Research and Quality.
[8]
Cui, A., Li, H., Wang, D., Zhong, J., Chen, Y. and Lu, H. (2020) Global, Regional Prevalence, Incidence and Risk Factors of Knee Osteoarthritis in Population-Based Studies. eClinicalMedicine, 29, Article ID: 100587. https://doi.org/10.1016/j.eclinm.2020.100587
[9]
Zhang, Y.Q. and Jordan, J.M. (2010) Epidemiology of Osteoarthritis. Clinics in Geriatric Medicine, 26, 355-369. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2920533/
[10]
Srikanth, V.K., Fryer, J.L., Zhai, G., Winzenberg, T.M., Hosmer, D. and Jones, G. (2005) A Meta-Analysis of Sex Differences Prevalence, Incidence and Severity of Osteoarthritis. Osteoarthritis and Cartilage, 13, 769-781. https://doi.org/10.1016/j.joca.2005.04.014
[11]
Wluka, A.E., Cicuttini, F.M. and Spector, T.D. (2000) Menopause, Oestrogens and Arthritis. Maturitas, 35, 183-199. https://doi.org/10.1016/s0378-5122(00)00118-3
[12]
Nevitt, M.C. (1996) Association of Estrogen Replacement Therapy with the Risk of Osteoarthritis of the Hip in Elderly White Women. Archives of Internal Medicine, 156, 2073-2080. https://doi.org/10.1001/archinte.1996.00440170081009
[13]
Nevitt, M.C., Felson, D.T., Williams, E.N. and Grady, D. (2001) The Effect of Estrogen Plus Progestin on Knee Symptoms and Related Disability in Postmenopausal Women: The Heart and Estrogen/Progestin Replacement Study, a Randomized, Double-Blind, Placebo-Controlled Trial. Arthritis & Rheumatism, 44, 811-818. https://doi.org/10.1002/1529-0131(200104)44:4<811::aid-anr137>3.0.co;2-f
[14]
Cirillo, D.J., Wallace, R.B., Wu, L. and Yood, R.A. (2006) Effect of Hormone Therapy on Risk of Hip and Knee Joint Replacement in the Women’s Health Initiative. Arthritis & Rheumatism, 54, 3194-3204. https://doi.org/10.1002/art.22138
[15]
Spector, T.D., Cicuttini, F., Baker, J., Loughlin, J. and Hart, D. (1996) Genetic Influences on Osteoarthritis in Women: A Twin Study. BMJ, 312, 940-943. https://doi.org/10.1136/bmj.312.7036.940
[16]
Felson, D.T., Couropmitree, N.N., Chaisson, C.E., Hannan, M.T., Zhang, Y., McAlindon, T.E., et al. (1998) Evidence for a Mendelian Gene in a Segregation Analysis of Generalized Radiographic Osteoarthritis: The Framingham Study. Arthritis & Rheumatism, 41, 1064-1071. https://doi.org/10.1002/1529-0131(199806)41:6<1064::aid-art13>3.0.co;2-k
[17]
Kerkhof, H.J.M., Lories, R.J., Meulenbelt, I., Jonsdottir, I., Valdes, A.M., Arp, P., et al. (2010) A Genome-Wide Association Study Identifies an Osteoarthritis Susceptibility Locus on Chromosome 7q22. Arthritis & Rheumatism, 62, 499-510. https://doi.org/10.1002/art.27184
[18]
Dolan, A.L., Hart, D.J., Doyle, D.V., Grahame, R. and Spector, T.D. (2003) The Relationship of Joint Hypermobility, Bone Mineral Density, and Osteoarthritis in the General Population: The Chingford Study. The Journal of Rheumatology, 30, 799-803.
[19]
Chen, H., Shah, S.H., Li, Y., Stabler, T.V., Jordan, J.M. and Kraus, V.B. (2008) Inverse Association of General Joint Hypermobility with Hand and Knee Osteoarthritis and Serum Cartilage Oligomeric Matrix Protein Levels. Arthritis & Rheumatism, 58, 3854-3864. https://doi.org/10.1002/art.24319
[20]
Murray, R.O. (1965) The Aetiology of Primary Osteoarthritis of the Hip. The British Journal of Radiology, 38, 810-824. https://doi.org/10.1259/0007-1285-38-455-810
[21]
Stulberg, S.D., Cooperman, D.R. and Wallensten, R. (1981) The Natural History of Legg-Calvé-Perthes Disease. The Journal of Bone & Joint Surgery, 63, 1095-1108. https://doi.org/10.2106/00004623-198163070-00006
[22]
Harris, W.H. (1986) Etiology of Osteoarthritis of the Hip. Clinical Orthopaedics and Related Research, 213, 20-33. https://doi.org/10.1097/00003086-198612000-00004
[23]
Lane, N.E., Lin, P., Christiansen, L., Gore, L.R., Williams, E.N., Hochberg, M.C., et al. (2000) Association of Mild Acetabular Dysplasia with an Increased Risk of Incident Hip Osteoarthritis in Elderly White Women: The Study of Osteoporotic Fractures. Arthritis & Rheumatism, 43, 400-404. https://doi.org/10.1002/1529-0131(200002)43:2<400::aid-anr21>3.0.co;2-d
[24]
Croft, P., Cooper, C., Wickham, C. and Coggon, D. (1991) Osteoarthritis of the Hip and Acetabular Dysplasia. Annals of the Rheumatic Diseases, 50, 308-310. https://doi.org/10.1136/ard.50.5.308
[25]
Smith, R.W., Egger, P., Coggon, D., Cawley, M.I. and Cooper, C. (1995) Osteoarthritis of the Hip Joint and Acetabular Dysplasia in Women. Annals of the Rheumatic Diseases, 54, 179-181. https://doi.org/10.1136/ard.54.3.179
[26]
Lau, E.M., Lin, F., Lam, D., Silman, A. and Croft, P. (1995) Hip Osteoarthritis and Dysplasia in Chinese Men. Annals of the Rheumatic Diseases, 54, 965-969. https://doi.org/10.1136/ard.54.12.965
[27]
Lane, N.E., Nevitt, M.C., Cooper, C., Pressman, A., Gore, R. and Hochberg, M. (1997) Acetabular Dysplasia and Osteoarthritis of the Hip in Elderly White Women. Annals of the Rheumatic Diseases, 56, 627-630. https://doi.org/10.1136/ard.56.10.627
[28]
McAlindon, T.E., Felson, D.T., Zhang, Y., Hannan, M.T., Aliabadi, P., Weissman, B., et al. (1996) Relation of Dietary Intake and Serum Levels of Vitamin D to Progression of Osteoarthritis of the Knee among Participants in the Framingham Study. Annals of Internal Medicine, 125, 353-359. https://doi.org/10.7326/0003-4819-125-5-199609010-00001
[29]
Felson, D.T., Niu, J., Clancy, M., Aliabadi, P., Sack, B., Guermazi, A., et al. (2007) Low Levels of Vitamin D and Worsening of Knee Osteoarthritis: Results of Two Longitudinal Studies. Arthritis & Rheumatism, 56, 129-136. https://doi.org/10.1002/art.22292
[30]
McAlindon, T., LaValley, M., Schneider, E., Nuite, M., Lee, J.Y., Price, L.L., et al. (2013) Effect of Vitamin D Supplementation on Progression of Knee Pain and Cartilage Volume Loss in Patients with Symptomatic Osteoarthritis. JAMA, 309, 155-162. https://doi.org/10.1001/jama.2012.164487
[31]
American Academy of Orthopaedic Surgeons (n.d.) Clinical Practice Guideline on Management of Osteoarthritis of the Knee, 3rd Edition. Osteoarthritis of the Knee—Clinical Practice Guideline (CPG).
[32]
Akamatsu, Y., Koshino, T., Saito, T. and Wada, J. (1997) Changes in Osteosclerosis of the Osteoarthritic Knee after High Tibial Osteotomy, Clinical Orthopaedics and Related Research, 334, 207-214. https://doi.org/10.1097/00003086-199701000-00027
[33]
Lee, D.C. and Byun, S.J. (2012) High Tibial Osteotomy. Knee Surgery & Related Research, 24, 61-69. https://doi.org/10.5792/ksrr.2012.24.2.61
