Please enter verification code
Effect of Postoperative Exercise Program on Knee Physical Function Among High Tibial Osteotomy Patients
American Journal of Nursing Science
Volume 9, Issue 4, August 2020, Pages: 258-266
Received: Jun. 21, 2020; Accepted: Jul. 7, 2020; Published: Jul. 17, 2020
Views 359      Downloads 128
Hesham Abd El-Rahim Elkady, Orthopedic Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt
Nagwa Mohamed Ahmed, Orthopedic Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt
Shimaa Hussien, Medical-Surgical Nursing, Faculty of Nursing, Assiut University, Assiut, Egypt
Marwa Ali, Medical-Surgical Nursing, Faculty of Nursing, Assiut University, Assiut, Egypt
Article Tools
Follow on us
Background: High tibial osteotomy is preferential treatment for patients with knee osteoarthritis. Strengthening exercise program helps post (HTO) patients achieve greater functioning during sport, recreation, and activities of daily living after surgery. Objective: To examine the effect of postoperative exercise program on knee physical function among high tibial osteotomy patients. Method: Design: quasi experimental research design. Setting: Department of Orthopedic Surgery and orthopedic Outpatient Clinic at Assiut University Hospital. Sample: A purposive sample of 60 adult patients undergoing high tibial osteotomy were included in our study. Method: Knee Outcome Survey Activities of Daily Living Scale and Lysholm knee scoring scale were used. Results: A highly statistically significant improvement of knee Function score and Lysholm knee score (<0.001**) among patients with high tibial osteotomy. Conclusion: Application of exercise program had a statistically significant effect on improvement physical function of knee among the study group than among the control group. Recommendations: Successful postoperative exercises should be practiced for each patient undergoing high tibial osteotomy in order to improving physical function of the knee.
Exercise Program, Knee Physical Function, High Tibial Osteotomy
To cite this article
Hesham Abd El-Rahim Elkady, Nagwa Mohamed Ahmed, Shimaa Hussien, Marwa Ali, Effect of Postoperative Exercise Program on Knee Physical Function Among High Tibial Osteotomy Patients, American Journal of Nursing Science. Vol. 9, No. 4, 2020, pp. 258-266. doi: 10.11648/j.ajns.20200904.27
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Shahcheraghi, G. H., Zarae, P., Javid, M. and Mahmoodian, B., (2007): High tibial valgus osteotomy and functional outcome. Iranian Journal of Medical Sciences, 32 (2), pp. 66-73.
Elson D., Paweleck J., Shields D., Dawson M., Ferrier G., (2013): Stretching the indications: high tibial osteotomy used successfully to treat isolated ankle symptoms. Case Reports, 2013, bcr2013200527.
Niemeyer P., Schmal H., Hauschild O., von Heyden J., Südkamp N., Köstler W., (2010): Open-wedge osteotomy using an internal plate fixator in patients with medial-compartment gonarthritis and varus malalignment: 3-year results with regard to preoperative arthroscopic and radiographic findings. Arthroscopy. 26 (12): 1607-16.
Amendola A, Bonasia DE, (2010): Results of high tibial osteotomy: review of the literature. Int Orthop. 2010; 34: 155–160.
Savarese E., Bisicchia S., Romeo R., Amendola N., (2011): A. Role of high tibial osteotomy in chronic injuries of posterior cruciate ligament and posterolateral corner. J Orthop Traumatol. 12: 1–17.
Asada S., Akagi M., Mori S., Matsushita T., Hashimoto K., Hamanishi C., (2012): Increase in posterior tibial slope would result in correction loss in frontal plane after medial open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc. 2012; 20 (3): 571-8.
Song E., Seon J., Park S., Jeong M., (2010): The complications of high tibial osteotomy: closing- versus opening-wedge methods. J Bone Joint Surg Br. 92: 1245–1252.
Frank R., Noyes D., Barber-W., (2017): In Noyes' Knee Disorders: Surgery, Rehabilitation, Clinical Outcomes (Second Edition).
Rossi R., Bonasia D., Amendola A., (2011): The role of high tibial osteotomy in the varus knee. J Am Acad Orthop Surg. 19: 590–599.
Irrgang J, Snyder-Mackler L, Wainner R, Fu F, Harner C., (1998) Development of a patient-reported measure of function of the knee. Journal of Bone Joint Surgery - American Volume 1998; 80-A (8): 1132-1145. Knee Outcome Survey Activities of Daily Living Scale (ADLS).
Tegner Y, Lysholm J., (1985): Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res. 1985 Sep; (198): 43-9.
Niinimak K., Eskelinen A., Mann B., Junnila M., Ohtonen P., Leppilahti J., (2012): Survivorship of high tibial osteotomy in the treatment of osteoarthritis of high-tibial osteotomy. Knee surg sports traumatol Arthrosc. 14: 149-152.
Aalderink J., Shaffer M., Amendola A., (2010): Rehabilitation Following High Tibial Osteotomy. Clin Sports Med. 29: 291-301.
Pannell W., Heidari K., Mayer E., Zimmerman K., Heckmann N., McKnight B., Hill J., Vangsness C, Hatch G and Weber A (2019): High Tibial Osteotomy Survivorship, A Population-Based Study, The Orthopaedic Journal of Sports Medicine, 7 (12).
Ihle C., Ateschrang A., Grünwald L., töckle U., Saier T and Schröter S., (2016): Health-related quality of life and clinical outcomes following medial open wedge high tibial osteotomy: a prospective study, Musculoskeletal Disorders 17: 215, DOI 10.1186/s12891-016-1076-x.
Van Egmond N, Stolwijk N., Van Heerwaarden R., Van Kampen A., Keijsers N., (2016): Gait analysis before and after corrective osteotomy in patients with knee osteoarthritis and a valgus deformity, Knee Surg Sports Traumatol Arthrosc.
Bode G., Heyden J., Pestka J., Schmal H., Salzmann G., Sudkamp N., Niemeyer P., (2015): Prospective 5-year survival rate data following open-wedge valgus high tibial osteotomy, Knee Surg Sports Traumatol Arthrosc 23: 1949-1955 DOI 10.1007/s00167-013-2762-y
Trevor B., Giffin J., Bert M., Chesworth A., Dianne M., Robert B., Kevin W, Thomas R., and Peter J (2009): medial opening wedge high tibial osteotomy: a prospective cohort study of gait, radiographic, and patient-reported outcomes, Arthritis & Rheumatism (arthritis care & research), American College of Rheumatology, Vol. 61, No. 5, may 15, 2009, pp 648 657.
Yokoyama M., Nakamura Y., Onishi T, Hirano K., and Motoyuki D., (2016): Healing period after open high tibial osteotomy and related factors: Can we really say that it is long, Springer Plus.
Hoorntje A., Paul F., Koen L., Rutger C., Gino M., and Ronald J. (2019): Prognostic Factors for Return to Sport After High Tibial Osteotomy Investigation performed at Sint Maartenskliniek Woerden, Woerden, the Netherlands, The American Journal of Sports Medicine, 47 (8): 1854-1862, DOI: 10. 1177/0363546519849476.
Benzakour T & Hefti A & Lemseffer M & El Ahmadi J & Bouyarmane H & Benzakour A, (2010): High tibial osteotomy for medial osteoarthritis of the knee: 15 years follow-up, International Orthopaedics (SICOT) 34: 209-215
Liu N., Agarwalla A. Garcia G., Christian D., Gowd A, Yanke A., Cole B., (2019): Return to Sport and Work After High Tibial Osteotomy With Concomitant Medial Meniscal Allograft Transplant, Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol -, No - (Month), 2019: pp 1-7.
Smith O., Wilson A., Thomas P., (2013): Osteotomy around the knee: evolution, principles and results. Knee Surg Sports Traumatol Arthrosc. 2013; 21 (1): 3-22.
Bonasia D., Dettoni F., Sito G., (2014): Medial opening wedge high tibial osteotomy for medial compartment overload/arthritis in the varus knee: prognostic factors. Am J sports Med. 42: 690-698.
Akizuki S., shibakawa A., takizawa T., (2008): The long-term outcome of high tibial osteotomy: a ten- to 20-year followup. J Bone Joint surg Br. 90: 592-596.
Siboni R., Beaufils P., Boisrenoult P., Steltzlen C., Pujol N., (2018): pening-wedge high tibial osteotomy without bone grafting in severe varus osteoarthritic knee. Rate and risk factors of non-union in 41 cases, France Orthopaedics & Traumatology: Surgery & Research, 104 473-476.
Briem, K., & Snyder‐Mackler, L. (2009). Proximal gait adaptations in medial knee OA. Journal of Orthopaedic Research, 27 (1), 78-83.
Annette W., Larsen S., Roos E., (2009): Association between knee alignment and knee pain in patients surgically treated for medial knee osteoarthritis by high tibial osteotomy. A one year follow-up study, BMC Musculoskeletal Disorders, 10: 154 doi: 10.1186/1471-2474-10-154
Duivenvoorden T., Brouwer R., Baan A., (2014): Comparison of closing-wedge and opening-wedge high tibial osteotomy for medial compartment osteoarthritis of the knee: a randomized controlled trial with a six-year follow-up. J Bone Joint surg Am. 96: 1425-1432.
Harris J., Mcneilan R., siston R., (2013): Survival and clinical outcome of isolated high tibial osteotomy and combined biological knee reconstruction. Knee.; 20: 154-161.
Martin R., Birmingham B., Willits K., (2014): Adverse event rates and classifications in medial opening wedge high tibial osteotomy. Am J sports Med. 42: 1118-1126.
Saragaglia D., Rouchy R., Krayan A., (2014): Return to sports after valgus osteotomy of the knee joint in patients with medial unicompartmental osteoarthritis. int orthop. 38: 2109-2114
Sun H., Zhou L., Li F., Duan J. (2017): Comparison between closing-wedge and opening-wedge high tibial osteotomy in patients with medial knee osteoarthritis: a systematic review and meta-analysis. The Journal of Knee Surgery. 30 (2): 158–165. doi: 10.1055/s-0036-1584189.
Floerkemeier S., staubli A., schroeter S., (2013): Outcome after high tibial open-wedge osteotomy: a retrospective evaluation of 533 patients. Knee surg sports traumatol Arthrosc. 21: 170-180.
Soleimanpour J., Elmi A., Jafari MA., (2013): Comparison of Comparison of Genu Varum Treating Results Using Open and Closed Wedge High Tibial Osteotomy, Pakistan Journal of Biological Sciences 16 (14): 686-91.
Deie M., Hoso T., shimada N., (2014): Differences between opening versus closing high tibial osteotomy on clinical outcomes and gait analysis. Knee. 21: 1046-1051.
Brouwer R., Bierma M., van Raaij., (2006): osteotomy for medial compartment arthritis of the knee using a closing wedge or an opening wedge controlled by a Puddu plate. A one-year randomised, controlled study. J Bone Joint surg Br. 88: 1454-1459.
Jin M., Holloway E., (2013): The young osteoarthritic knee: dilemmas in management. BMC Medicine. 2013; 11 (1): p. 14. doi: 10.1186/1741-7015-11-14.
Kutzner I., Heinlein B., Graichen F., (2010): Loading of the knee joint during activities of daily living measured in vivo in five subjects. Journal of Biomechanics.; 43 (11): 2164–2173. doi: 10.1016/j. jbiomech. 03. 046.
Erquicia J., Eduardo P., Perelli S., Ibañez F., Ibañez M., Pelfort X and Carlos J., (2019): Biplane opening wedge high tibial osteotomy with a distal tuberosity osteotomy, radiological and clinical analysis with minimum follow-up of 2 years, Journal of Experimental Orthopaedics, 10.1186/s40634-019-0176-6.
Chen Z., Zhang X., Ardestani M., (2014): Prediction of in vivo joint mechanics of an artificial knee implant using rigid multi-body dynamics with elastic contacts. Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine; 228 (6): 564–575. doi: 10.1177/0954411914537476.
Da Cunha r., Kraszewski a., Hillstrom H., Fragomen A., Rozbruch S., (2019): Biomechanical and Functional Improvements Gained by Proximal Tibia Osteotomy Correction of Genu Varum in Patientswith Knee Pain, HSSJ Journal, DOI 10.1007/s11420-019-09670-6.
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
Tel: (001)347-983-5186