Clinical outcomes and long-term efficacy of high tibial osteotomy in treating knee instability: An updated systematic review

Introduction: Knee joint stability is influenced by force distribution and ligament structures. High Tibial Osteotomy (HTO) treats knee deformities and redistributes load, reducing further invasive procedures. High Tibial Osteotomy (HTO) is a well-established procedure for addressing knee instabilit...

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Main Authors: Mustamsir Edi, Aji Aulia Pandu, Adiwangsa Ahmad Abdilla, Akmalizzan Azfar Ahnaf
Format: Article
Language:English
Published: EDP Sciences 2025-01-01
Series:SICOT-J
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Online Access:https://www.sicot-j.org/articles/sicotj/full_html/2025/01/sicotj240073/sicotj240073.html
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author Mustamsir Edi
Aji Aulia Pandu
Adiwangsa Ahmad Abdilla
Akmalizzan Azfar Ahnaf
author_facet Mustamsir Edi
Aji Aulia Pandu
Adiwangsa Ahmad Abdilla
Akmalizzan Azfar Ahnaf
author_sort Mustamsir Edi
collection DOAJ
description Introduction: Knee joint stability is influenced by force distribution and ligament structures. High Tibial Osteotomy (HTO) treats knee deformities and redistributes load, reducing further invasive procedures. High Tibial Osteotomy (HTO) is a well-established procedure for addressing knee instability, particularly in cases involving ligament deficiencies such as ACL and PCL insufficiencies. This systematic review aims to evaluate the clinical outcomes and long-term efficacy of HTO in improving knee stability and function. Methods: A systematic literature search was conducted using Cochrane Central, PubMed, MEDLINE, and ProQuest databases for studies published between 2000 and June 2024. Eligible studies included human subjects with at least six months of follow-up and focused on HTO for knee instability. Exclusion criteria included animal studies, non-knee joint studies, and reviews. Data on patient demographics, follow-up duration, subjective and objective outcomes, and complications were extracted. Results: Out of 536 studies identified, 11 met the inclusion criteria, encompassing 303 patients. Combining HTO with ACL or PCL reconstruction significantly improved both subjective instability and objective measures, including Lachman and Pivot Shift test grades. Patient satisfaction was high, and functional scores such as Lysholm and Tegner improved markedly. The incidence of complications was low, with minor issues such as infections and delayed union, and no reported graft failures. Conclusion: HTO, particularly when combined with ligament reconstruction, effectively treats knee instability due to ACL or PCL deficiency. The procedure demonstrates strong mid- to long-term outcomes, high patient satisfaction, and a low rate of complications. It remains a viable option for patients with knee instability.
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spelling doaj-art-5e007087e7f04f0f806ef3ec31a3b59b2025-02-07T08:31:35ZengEDP SciencesSICOT-J2426-88872025-01-0111610.1051/sicotj/2024061sicotj240073Clinical outcomes and long-term efficacy of high tibial osteotomy in treating knee instability: An updated systematic reviewMustamsir Edi0https://orcid.org/0000-0002-8914-6166Aji Aulia Pandu1https://orcid.org/0009-0007-7086-5009Adiwangsa Ahmad Abdilla2Akmalizzan Azfar Ahnaf3https://orcid.org/0009-0007-7582-2868Orthopaedics and Traumatology Department, Faculty of Medicine, Brawijaya University – Saiful Anwar General HospitalGeneral PractitionerBhayangkara HospitalNgudi Waluyo General HospitalIntroduction: Knee joint stability is influenced by force distribution and ligament structures. High Tibial Osteotomy (HTO) treats knee deformities and redistributes load, reducing further invasive procedures. High Tibial Osteotomy (HTO) is a well-established procedure for addressing knee instability, particularly in cases involving ligament deficiencies such as ACL and PCL insufficiencies. This systematic review aims to evaluate the clinical outcomes and long-term efficacy of HTO in improving knee stability and function. Methods: A systematic literature search was conducted using Cochrane Central, PubMed, MEDLINE, and ProQuest databases for studies published between 2000 and June 2024. Eligible studies included human subjects with at least six months of follow-up and focused on HTO for knee instability. Exclusion criteria included animal studies, non-knee joint studies, and reviews. Data on patient demographics, follow-up duration, subjective and objective outcomes, and complications were extracted. Results: Out of 536 studies identified, 11 met the inclusion criteria, encompassing 303 patients. Combining HTO with ACL or PCL reconstruction significantly improved both subjective instability and objective measures, including Lachman and Pivot Shift test grades. Patient satisfaction was high, and functional scores such as Lysholm and Tegner improved markedly. The incidence of complications was low, with minor issues such as infections and delayed union, and no reported graft failures. Conclusion: HTO, particularly when combined with ligament reconstruction, effectively treats knee instability due to ACL or PCL deficiency. The procedure demonstrates strong mid- to long-term outcomes, high patient satisfaction, and a low rate of complications. It remains a viable option for patients with knee instability.https://www.sicot-j.org/articles/sicotj/full_html/2025/01/sicotj240073/sicotj240073.htmlhtooutcomesinstabilitytibialslope
spellingShingle Mustamsir Edi
Aji Aulia Pandu
Adiwangsa Ahmad Abdilla
Akmalizzan Azfar Ahnaf
Clinical outcomes and long-term efficacy of high tibial osteotomy in treating knee instability: An updated systematic review
SICOT-J
hto
outcomes
instability
tibial
slope
title Clinical outcomes and long-term efficacy of high tibial osteotomy in treating knee instability: An updated systematic review
title_full Clinical outcomes and long-term efficacy of high tibial osteotomy in treating knee instability: An updated systematic review
title_fullStr Clinical outcomes and long-term efficacy of high tibial osteotomy in treating knee instability: An updated systematic review
title_full_unstemmed Clinical outcomes and long-term efficacy of high tibial osteotomy in treating knee instability: An updated systematic review
title_short Clinical outcomes and long-term efficacy of high tibial osteotomy in treating knee instability: An updated systematic review
title_sort clinical outcomes and long term efficacy of high tibial osteotomy in treating knee instability an updated systematic review
topic hto
outcomes
instability
tibial
slope
url https://www.sicot-j.org/articles/sicotj/full_html/2025/01/sicotj240073/sicotj240073.html
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