Functional outcome after high tibial osteotomy: a study using individual goal achievement as the primary outcome variable.

Functional outcome after high tibial osteotomy (HTO) was evaluated with respect to both improvement and goal achievement. Fifty-seven subjects, 32 men and 25 women, with a mean age of 55 years were examined with the Functional Assessment System (FAS) 6 and 12 months after surgery. The FAS is an evaluation system, specifically designed to monitor lower extremity dysfunction. It shows a profile with preoperative status, individual goal, and postoperative status. Statistically significant improvement was seen in 6/20 variables after 6 months, and in 10/20 variables after 12 months. When goal achievement was examined, the results were not as impressive. The treatment goal was not reached on the group level for almost all variables. On the individual level, only 20\N40% of the patients achieved the goal as a result of surgery in most variables. Exceptions were pain and leisure time/hobbies, where there was a high degree of goal achievement. It is possible that postoperative training was inadequate. The authors recommend a new randomized study, where patients who receive specific individual training related to the individual goal and functional profile are compared with a control group.