Tan Ashton Kai Shun, Tao Xinyu, Teo Shao Jin, Koh Don Thong Siang, Soong Junwei, Razak Hamid Rahmatullah Bin Abd, Lee Kong Hwee
Department of Orthopaedic Surgery Singapore General Hospital Singapore Singapore.
Total Orthopaedic Care & Surgery Singapore Singapore.
J Exp Orthop. 2025 Sep 4;12(3):e70400. doi: 10.1002/jeo2.70400. eCollection 2025 Jul.
Knee osteoarthritis (OA) is the most common degenerative joint disease in the world. It results in not only physical limitation and pain, but also negatively impacts quality of life and mental wellbeing. Treatment options such as medial opening wedge high tibial osteotomy (MOWHTO) help to relieve pain and improve functionality, but there is limited literature on the effect on mental health. This study aims to investigate the effect of MOWHTO on the mental health of patients with knee OA.
In this retrospective cohort study, data were collected from patients who underwent MOWHTO between 2019 and 2023 in a single tertiary institution. The main outcome score, short form-36 mental component score (SF-36 MCS), was recorded at baseline, 6 months and 2 years postprocedure. Secondary outcomes included the SF-36 physical component score (PCS) and Oxford knee score (OKS).
There were a total of 108 MOWHTOs, comprising 51 men and 57 women. At surgery, the mean age was 55.4 ± 6.97. Twelve patients did not turn up at the 6-month follow-up. There was a significant improvement of SF-36 MCS from a preoperative mean of 50.8 ± 12.6 to 57.1 ± 11.0 ( < 0.05) and 56.8 + 9.07 ( < 0.05) at 6 months and 2 years postoperation, respectively. There was also a significant increase in the scores of SF-36 PCS and OKS ( < 0.05 for both) at 6-month and 2-year follow-up. Higher preoperative SF-36 MCS was significantly correlated with improved postoperation SF-36 PCS ( = 0.184, = 0.05) and OKS ( = -0.218, = 0.02 < 0.05).
At 2-year follow-up, MOWHTO results in a significant improvement in the mental health of patients with knee OA. There is a correlation between preoperative mental health and postoperative outcomes, suggesting a role of mental health in affecting MOWHTO outcomes.
Level IV.
膝关节骨关节炎（OA）是世界上最常见的退行性关节疾病。它不仅导致身体活动受限和疼痛，还会对生活质量和心理健康产生负面影响。诸如内侧开口楔形高位胫骨截骨术（MOWHTO）等治疗方法有助于缓解疼痛并改善功能，但关于其对心理健康影响的文献有限。本研究旨在调查MOWHTO对膝关节OA患者心理健康的影响。
在这项回顾性队列研究中，收集了2019年至2023年在一家三级医疗机构接受MOWHTO治疗的患者的数据。主要结局指标，即简明健康状况调查量表精神健康分量表（SF - 36 MCS），在术前、术后6个月和2年进行记录。次要结局指标包括SF - 36生理健康分量表（PCS）和牛津膝关节评分（OKS）。
共进行了108例MOWHTO手术，其中男性51例，女性57例。手术时的平均年龄为55.4±6.97岁。12例患者未参加6个月的随访。SF - 36 MCS从术前平均50.8±12.6显著改善至术后6个月的57.1±11.0（P<0.05）以及术后2年的56.8 + 9.07（P<0.05）。在6个月和2年随访时，SF - 36 PCS和OKS评分也显著增加（两者P<0.05）。术前较高的SF - 36 MCS与术后改善的SF - 36 PCS（r = 0.184，P = 0.05）和OKS（r = -0.218，P = 0.02<0.05）显著相关。
在2年随访时，MOWHTO可使膝关节OA患者的心理健康得到显著改善。术前心理健康状况与术后结局之间存在相关性，提示心理健康在影响MOWHTO结局中发挥作用。
四级。
