{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T03:30:47Z","timestamp":1780457447569,"version":"3.54.1"},"reference-count":28,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T00:00:00Z","timestamp":1719446400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>This study investigates the effect of the body mass index (BMI) on the early (2 years) to midterm (5 years) results of medial opening wedge high tibial osteotomy (MOWHTO).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospectively maintained single\u2010centre database of 1138 knee osteotomies, between 2002 and\u00a02022, was retrospectively reviewed. Adult patients who underwent MOWHTO for symptomatic unicompartmental medial knee osteoarthritis (OA), with varus knee malalignment, having failed conservative management, were included. Patients were categorized into three\u00a0groups according to their BMI as per the classification from the National Institute for Health and Care Excellence (NICE): the healthy weight (HW) group (BMI of 18.5\u201324.9\u2009kg\/m<jats:sup>2<\/jats:sup>), the overweight (OW) (BMI of 25\u201329.9\u2009kg\/m<jats:sup>2<\/jats:sup>), and the obesity (OB) group (BMI\u2009\u2265\u200930\u2009kg\/m<jats:sup>2<\/jats:sup>). Multiple patient\u2010reported outcome measures (<jats:italic>n<\/jats:italic>\u2009=\u20096) were recorded preoperatively and at 2 and 5 years postoperatively. Deformity analysis was undertaken preoperatively and postoperatively. The relative risk (RR) of the complications between the HW, OW\u00a0and OB groups was calculated. The rate of conversion to arthroplasty, and 5\u00a0and 10 years survivorship were recorded, as well as the hazard ratio (HR) of BMI on survivorship.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 574 cases were included in the study: the HW group (<jats:italic>n<\/jats:italic>\u2009=\u200996), the OW group (<jats:italic>n<\/jats:italic>\u2009=\u2009233)\u00a0and the OB group (<jats:italic>n<\/jats:italic>\u2009=\u2009245), with a mean BMI of 23\u2009\u00b1\u20091.5\u2009kg\/m<jats:sup>2<\/jats:sup>, 27.4\u2009\u00b1\u20091.4\u2009kg\/m<jats:sup>2<\/jats:sup> and 34.4\u2009\u00b1\u20093.8\u2009kg\/m<jats:sup>2<\/jats:sup>, respectively. The mean follow\u2010up was 13.3 years (4.8\u201320.3). The mean mechanical tibiofemoral angle corrections were in the HW group: 7.1\u2009\u00b1\u20093\u00b0, OW group: 6.6\u2009\u00b1\u20093.5\u00b0\u00a0and OB group: 7.1\u2009\u00b1\u20093.8\u00b0, with no intergroup significant difference (<jats:italic>p<\/jats:italic>\u2009=\u2009n.s.). Clinically, despite lower preoperative scores in the OW and OB groups, no difference was observed postoperatively amongst the three groups. The overall complication rate was 12.5% in the HW group, 6.8% in the OW group, and 9.8% in the OB group. There was no significant difference in the RR of complications between the HW and OW groups (RR\u2009=\u20090.6, 95% confidence interval [CI]\u2009=\u20090.3\u20131.3)\u00a0(<jats:italic>p<\/jats:italic>\u2009=\u20090.2), and the HW and OB groups (RR\u2009=\u20090.8; 95% CI\u2009=\u20090.3\u20132.2)\u00a0(<jats:italic>p<\/jats:italic>\u2009=\u20090.7). There was no overall significant difference in survival outcomes based on the BMI between the three\u00a0groups (<jats:italic>p<\/jats:italic>\u2009=\u20090.4). The HR of conversion to arthroplasty between the HW and OW groups was 1.4 [95% CI\u2009=\u20090.6\u20133.5](<jats:italic>p<\/jats:italic>\u2009=\u20090.5)\u00a0and between the HW and OB groups was 1.8 [95% CI\u2009=\u20090.8\u20134.4] (<jats:italic>p<\/jats:italic>\u2009=\u20090.2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>BMI has no significant effect on either the radiological corrections, clinical outcomes, complications\u00a0or survivorship of MOWHTO at short\u2010 to medium\u2010term follow\u2010up. No specific cutoff point for BMI can be recommended as a contraindication to MOWHTO.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Level IV, Retrospective cohort study.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ksa.12317","type":"journal-article","created":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T03:06:24Z","timestamp":1719457584000},"page":"2328-2341","source":"Crossref","is-referenced-by-count":7,"title":["Medial opening wedge high tibial osteotomy performs similarly irrespective of body mass index"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2547-3176","authenticated-orcid":false,"given":"Ahmed","family":"Mabrouk","sequence":"first","affiliation":[{"name":"Department of Trauma and Orthopaedics Basingstoke and North Hampshire Hospital Basingstoke UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Risebury","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics Basingstoke and North Hampshire Hospital Basingstoke UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Yasen","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics Basingstoke and North Hampshire Hospital Basingstoke UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,27]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.artd.2023.101169"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-022-04997-4"},{"key":"e_1_2_12_4_1","unstructured":"BOA Commissioning Guides. 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