Article

We conducted a meta-analysis to analyze how high tibial osteotomy (HTO) changes
gait and focused on the following questions: (1) How does HTO change basic gait
variables? (2) How does HTO change the gait variables in the knee joint? Twelve
articles were included in the final analysis. A total of 383 knees was evaluated.
There were 237 open wedge (OW) and 143 closed wedge (CW) HTOs. There were 4 level
II studies and 8 level III studies. All studies included gait analysis and
compared pre- and postoperative values. One study compared CWHTO and
unicompartmental knee arthroplasty (UKA), and another study compared CWHTO and
OWHTO. Five studies compared gait variables with those of healthy controls. One
study compared operated limb gait variables with those in the non-operated limb.
Gait speed, stride length, knee adduction moment, and lateral thrust were major
variables assessed in 2 or more studies. Walking speed increased and stride
length was increased or similar after HTO compared to the preoperative value in
basic gait variables. Knee adduction moment and lateral thrust were decreased
after HTO compared to the preoperative knee joint gait variables. Change in
co-contraction of the medial side muscle after surgery differed depending on the
degree of frontal plane alignment. The relationship between change in knee
adduction moment and change in mechanical axis angle was controversial. Based on
our systematic review and meta-analysis, walking speed and stride length
increased after HTO. Knee adduction moment and lateral thrust decreased after HTO
compared to the preoperative values of gait variables in the knee joint.
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Langue : ANGLAIS