ArticleBone & joint open2025
What is the clinical and cost-effectiveness of surgery with Medial Opening wedge high TIbial Osteotomy compared with Non-surgical treatment (MOTION) in the management of osteoarthritis of the knee in patients younger than 60 years? : a protocol for a multicentre, randomized controlled trial.
Article in Bone & joint open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
15 authors.
Funding
Abstract
Aims: For patients aged < 60 years with symptomatic medial compartment knee osteoarthritis (OA), there is uncertainty regarding the most effective management (surgical or non-surgical). Surgical realignment with a high tibial osteotomy (HTO) can relieve pain and improve function, while also potentially avoiding or delaying a knee arthroplasty. However, HTO has never been compared with non-surgical treatment in this patient group. MOTION (Medial Opening wedge high TIbial Osteotomy compared with Non-surgical treatment) aims to determine the relative clinical effectiveness and cost-effectiveness of HTO compared with non-surgical management for patients aged < 60 years with medial compartment knee OA. Methods: MOTION is a pragmatic, multicentre, prospective randomized open blinded endpoint (PROBE) parallel group-controlled superiority trial. A total of 224 patients (112 per arm) will be recruited from approximately 20 UK sites. Patients aged < 60 years with moderate to severe symptomatic knee OA localized to the medial compartment, in whom surgical intervention is indicated, are eligible. The intervention is surgery with medial opening wedge HTO followed by standard postoperative rehabilitation, compared with a non-surgical intervention in the form of personalized knee therapy (PKT) focused on a structured, progressive, and tailored exercise programme of rehabilitation. Participants will be randomly assigned to one of the two treatment arms in a 1:1 ratio. The primary outcome is the Knee Injury and Osteoarthritis Outcome Score (KOOS) at 24 months post randomization. Secondary outcomes include the Oxford Knee Score (OKS), Forgotten Joint Score (FJS), EuroQol five-dimension questionnaire (EQ-5D), Sleep Problem Scale, return to work, need for secondary surgical intervention, and adverse events at 12 and 24 months. Health economic evaluation will determine the cost-effectiveness of the interventions. MOTION is funded by the National Institute for Health and Care Research (Ref: NIHR129820). Discussion: MOTION aims to determine whether HTO is a superior option to non-surgical management (PKT) for patients aged < 60 years with medial compartment knee OA with regard to both the clinical benefit for patients and cost-effectiveness for the NHS.
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