Changes in Knee Extension and Flexion Muscle Strength Measured by an Isokinetic Dynamometer after High Tibial Osteotomy: Comparison of Hybrid Closed Wedge HTO and Medial Open Wedge HTO
[Purpose] We evaluated the isokinetic knee muscle strength, from before surgery to 6 months after surgery, for both hybrid closed wedge high tibial osteotomy (HCWHTO) and medial open wedge high tibial osteotomy (MOWHTO). [Participants and Methods] This study included 21 patients with HCWHTO and 26 p...
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| Published in | Rigaku ryoho kagaku Vol. 40; no. 1; pp. 15 - 19 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | English Japanese |
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Tokyo
The Society of Physical Therapy Science
2025
理学療法科学学会 Japan Science and Technology Agency |
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| Online Access | Get full text |
| ISSN | 1341-1667 2434-2807 |
| DOI | 10.1589/rika.40.15 |
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| Abstract | [Purpose] We evaluated the isokinetic knee muscle strength, from before surgery to 6 months after surgery, for both hybrid closed wedge high tibial osteotomy (HCWHTO) and medial open wedge high tibial osteotomy (MOWHTO). [Participants and Methods] This study included 21 patients with HCWHTO and 26 patients with MOWHTO. The maximum torque-to-body weight ratio (%BW) and H/Q ratio were measured preoperatively, and at 3 and 6 months postoperatively. [Results] In HCWHTO, the knee flexion muscle strength significantly increased from pre- to 3 months post-operatively (p＜0.05). Knee extension muscle strength in MOWHTO significantly increased from pre- to 3 months post-operatively (p＜0.05). There were no significant differences in the H/Q ratio over time or between surgical procedures. [Conclusion] We consider that the difference in the timing of the start of post-operative loading between surgical procedures may have affected the course of muscle strength recovery. In order to improve clinical outcomes after HTO, strengthening the quadriceps muscle and reducing the H/Q ratio is considered important. |
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| AbstractList | [Purpose] We evaluated the isokinetic knee muscle strength, from before surgery to 6 months after surgery, for both hybrid closed wedge high tibial osteotomy (HCWHTO) and medial open wedge high tibial osteotomy (MOWHTO). [Participants and Methods] This study included 21 patients with HCWHTO and 26 patients with MOWHTO. The maximum torque-to-body weight ratio (%BW) and H/Q ratio were measured preoperatively, and at 3 and 6 months postoperatively. [Results] In HCWHTO, the knee flexion muscle strength significantly increased from pre- to 3 months post-operatively (p＜0.05). Knee extension muscle strength in MOWHTO significantly increased from pre- to 3 months post-operatively (p＜0.05). There were no significant differences in the H/Q ratio over time or between surgical procedures. [Conclusion] We consider that the difference in the timing of the start of post-operative loading between surgical procedures may have affected the course of muscle strength recovery. In order to improve clinical outcomes after HTO, strengthening the quadriceps muscle and reducing the H/Q ratio is considered important.
〔目的〕Hybrid closed wedge HTO（HCWHTO）とMedial open wedge HTO（MOWHTO）の術前から術後6ヵ月までの等速性膝筋力を調査した．〔対象と方法〕HCWHTOの21例とMOWHTOの26例を対象とした．術前，術後3ヵ月，術後6ヵ月時に最大トルク体重比（％BW）およびH/Q比を計測した．〔結果〕％BWは，HCWHTOでは膝屈曲筋力が術前から術後3ヵ月で有意に低下した．MOWHTOの膝伸展筋力は術前から術後6ヵ月，術後3ヵ月から術後6ヵ月で有意に増大した．H/Q比は経時的に術式間でも有意差はなかった．〔結語〕本研究では，術式間における荷重開始時期の違いが筋力回復の経過に影響を与えた可能性が考えられる． [Purpose] We evaluated the isokinetic knee muscle strength, from before surgery to 6 months after surgery, for both hybrid closed wedge high tibial osteotomy (HCWHTO) and medial open wedge high tibial osteotomy (MOWHTO). [Participants and Methods] This study included 21 patients with HCWHTO and 26 patients with MOWHTO. The maximum torque-to-body weight ratio (%BW) and H/Q ratio were measured preoperatively, and at 3 and 6 months postoperatively. [Results] In HCWHTO, the knee flexion muscle strength significantly increased from pre- to 3 months post-operatively (p＜0.05). Knee extension muscle strength in MOWHTO significantly increased from pre- to 3 months post-operatively (p＜0.05). There were no significant differences in the H/Q ratio over time or between surgical procedures. [Conclusion] We consider that the difference in the timing of the start of post-operative loading between surgical procedures may have affected the course of muscle strength recovery. In order to improve clinical outcomes after HTO, strengthening the quadriceps muscle and reducing the H/Q ratio is considered important. |
| Author | OGAWA, Takuya OKAMOTO, Michio YAMADA, Yuzo KONDO, Shusuke |
| Author_FL | 岡本 道雄 山田 裕三 KONDO Shusuke 小川 卓也 |
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| Copyright | 2025 by the Society of Physical Therapy Science 2025. This work is published under https://creativecommons.org/licenses/by-nc-nd/4.0/deed.ja (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. |
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| References | 12) Kawazoe T, Takahashi T: Recovery of muscle strength after high tibial osteotomy. J Orthop Sci, 2003, 8: 160-165. 1) 福田 航：Part III 変形性膝関節症に対する術後理学療法，4．HTO後における評価と治療戦略．In：極める変形性膝関節症の理学療法，山田英司（編），文光堂，東京，2014, pp225-234. 7) Akizuki S, Shibakawa A, Takizawa T, et al.: The long-term outcome of high tibial osteotomy: a ten- to 20-year follow-up. J Bone Joint Surg Br, 2008, 90: 592-596. 11) Rooks DS, Laurent D, Praestgaard J, et al.: Effect of bimagrumab on thigh muscle volume and composition in men with casting-induced atrophy. J Cachexia Sarcopenia Muscle, 2017, 8: 727-734. 5) Takeuchi R, Ishikawa H, Aratake M, et al.: Medial opening wedge high tibial osteotomy with early full weight bearing. Arthroscopy, 2009, 25: 46-53. 8) Sharma L, Dunlop DD, Cahue S, et al.: Quadriceps strength and osteoarthritis progression in malaligned and lax knees. Ann Intern Med, 2003, 138: 613-619. 6) Takeuchi R, Ishikawa H, Miyasaka Y, et al.: A novel closed-wedge high tibial osteotomy procedure to treat osteoarthritis of the knee: hybrid technique and rehabilitation measures. Arthrosc Tech, 2014, 3: e431-e437. 10) Horstman AM, Backx EM, Smeets JS, et al.: Nandrolone decanoate administration does not attenuate muscle atrophy during a short period of disuse. PLoS One, 2019, 14: e0210823. 3) Staubli AE, De Simoni C, Babst R, et al.: TomoFix: a new LCP-concept for open wedge osteotomy of the medial proximal tibia—early results in 92 cases. Injury, 2003, 34: B55-B62. 2) 安田和則：Ⅰ．骨切りの歴史，1．日本での流れ．In：ゼロからはじめる！Knee Osteotomyアップデート．日本Knee Osteotomyフォーラム（編），全日本病院出版会，東京，2018, pp2-6. 4) Floerkemeier S, Staubli AE, Schroeter S, et al.: Outcome after high tibial open-wedge osteotomy: a retrospective evaluation of 533 patients. Knee Surg Sports Traumatol Arthrosc, 2013, 21: 170-180. 9) 東 利紀，佐々木賢太郎，横田文子・他：高位脛骨骨り術後1年時点のJapanese Knee Injury and Osteoarthritis Outcome Score painに関連する因子の検討．運動器リハビリテーション，2021, 32: 429-434. 15) Slemenda C, Heilman DK, Brandt KD, et al.: Reduced quadriceps strength relative to body weight: a risk factor for knee osteoarthritis in women? Arthritis Rheum, 1998, 41: 1951-1959. 14) Kannus P, Järvinen M: Knee flexor/extensor strength ratio in follow-up of acute knee distortion injuries. Arch Phys Med Rehabil, 1990, 71: 38-41. 13) Campbell DE, Glenn W: Rehabilitation of knee flexor and knee extensor muscle strength in patients with meniscectomies, ligamentous repairs, and chondromalacia. Phys Ther, 1982, 62: 10-15. |
| References_xml | – reference: 3) Staubli AE, De Simoni C, Babst R, et al.: TomoFix: a new LCP-concept for open wedge osteotomy of the medial proximal tibia—early results in 92 cases. Injury, 2003, 34: B55-B62. – reference: 5) Takeuchi R, Ishikawa H, Aratake M, et al.: Medial opening wedge high tibial osteotomy with early full weight bearing. Arthroscopy, 2009, 25: 46-53. – reference: 12) Kawazoe T, Takahashi T: Recovery of muscle strength after high tibial osteotomy. J Orthop Sci, 2003, 8: 160-165. – reference: 8) Sharma L, Dunlop DD, Cahue S, et al.: Quadriceps strength and osteoarthritis progression in malaligned and lax knees. Ann Intern Med, 2003, 138: 613-619. – reference: 1) 福田 航：Part III 変形性膝関節症に対する術後理学療法，4．HTO後における評価と治療戦略．In：極める変形性膝関節症の理学療法，山田英司（編），文光堂，東京，2014, pp225-234. – reference: 6) Takeuchi R, Ishikawa H, Miyasaka Y, et al.: A novel closed-wedge high tibial osteotomy procedure to treat osteoarthritis of the knee: hybrid technique and rehabilitation measures. Arthrosc Tech, 2014, 3: e431-e437. – reference: 11) Rooks DS, Laurent D, Praestgaard J, et al.: Effect of bimagrumab on thigh muscle volume and composition in men with casting-induced atrophy. J Cachexia Sarcopenia Muscle, 2017, 8: 727-734. – reference: 9) 東 利紀，佐々木賢太郎，横田文子・他：高位脛骨骨り術後1年時点のJapanese Knee Injury and Osteoarthritis Outcome Score painに関連する因子の検討．運動器リハビリテーション，2021, 32: 429-434. – reference: 7) Akizuki S, Shibakawa A, Takizawa T, et al.: The long-term outcome of high tibial osteotomy: a ten- to 20-year follow-up. J Bone Joint Surg Br, 2008, 90: 592-596. – reference: 13) Campbell DE, Glenn W: Rehabilitation of knee flexor and knee extensor muscle strength in patients with meniscectomies, ligamentous repairs, and chondromalacia. Phys Ther, 1982, 62: 10-15. – reference: 14) Kannus P, Järvinen M: Knee flexor/extensor strength ratio in follow-up of acute knee distortion injuries. Arch Phys Med Rehabil, 1990, 71: 38-41. – reference: 15) Slemenda C, Heilman DK, Brandt KD, et al.: Reduced quadriceps strength relative to body weight: a risk factor for knee osteoarthritis in women? Arthritis Rheum, 1998, 41: 1951-1959. – reference: 4) Floerkemeier S, Staubli AE, Schroeter S, et al.: Outcome after high tibial open-wedge osteotomy: a retrospective evaluation of 533 patients. Knee Surg Sports Traumatol Arthrosc, 2013, 21: 170-180. – reference: 10) Horstman AM, Backx EM, Smeets JS, et al.: Nandrolone decanoate administration does not attenuate muscle atrophy during a short period of disuse. PLoS One, 2019, 14: e0210823. – reference: 2) 安田和則：Ⅰ．骨切りの歴史，1．日本での流れ．In：ゼロからはじめる！Knee Osteotomyアップデート．日本Knee Osteotomyフォーラム（編），全日本病院出版会，東京，2018, pp2-6. |
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| SubjectTerms | Clinical outcomes H/Q ratio H/Q比 high tibial osteotomy isokinetic muscle strength Muscle strength 等速性筋力 高位脛骨骨切り術 |
| Title | Changes in Knee Extension and Flexion Muscle Strength Measured by an Isokinetic Dynamometer after High Tibial Osteotomy: Comparison of Hybrid Closed Wedge HTO and Medial Open Wedge HTO |
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