Changes in patellar height and posterior tibial slope angle following uniplanar medial opening wedge high tibial osteotomy using a novel wedge-shaped spacer implanation concurrent with proximal partial fibulectomy

Prognostic Factors for Open-Wedge High Tibial Osteotomy with Spacer Implantation in Patients with Medial Compartmental Knee Osteoarthritis

“…Although there are few serious adverse events, the incidence of complications is higher after MOWHTO (28%) than that after TKA (7%) [28,29]. Third, MOWHTO is not the ultimate treatment for OA of the medial knee compartment, and the outcome of TKA performed after MOWHTO may be in uenced by factors such as the patellar height, condylar offset, and/or tibial inclination angle [19]. Therefore, clinical treatment must be guided by strict indications and predictors, especially for the novel spacer-type MOWHTO.…”

“…The HKAA, MPTA, and PTSA are corrected to a speci c high tibial osteotomy standard position to ensure the attainment of anatomic postoperative lower limb alignment and tibial plateau retroversion. Some studies have reported that a small HKAA (< 15°) is more suitable for spacer-type MOWHTO [18,19]. Therefore, we excluded patients with radiographic measurements that were outside the ranges suggested in the literature.…”

“…This new type of MOWHTO used a novel absorbable wedge-shaped spacer composed of 30% β-tricalcium phosphate and 70% poly (lactic-co-glycolic acid) instead of a locking compression plate system [18]. Compared with conventional MOWHTO, this novel method has a lower cost, avoids the need for secondary surgery for xation removal, and improves in radiographic appearance and knee function during follow-up [18,19]. Essentially, this type of absorbable spacer is a bone graft substitute that provides support in the open wedge without rigid internal xation; however, the longitudinal stability of the cut tibia cannot be guaranteed.…”

“…Essentially, this type of absorbable spacer is a bone graft substitute that provides support in the open wedge without rigid internal xation; however, the longitudinal stability of the cut tibia cannot be guaranteed. Zhang et al also performed simultaneous proximal bular osteotomy, which provides a better valgus orthopedic effect but may cause more complications or defects [18,19].…”

Prognostic factors for medial open-wedge high tibial osteotomy with spacer implantation in patients with medial compartmental knee osteoarthritis

“…This new type of MOWHTO used a novel absorbable wedge-shaped spacer composed of 30% β-tricalcium phosphate and 70% poly (lactic-co-glycolic acid) instead of a locking compression plate system [ 18 ]. Compared with conventional MOWHTO, this novel method has a lower cost, avoids the need for secondary surgery for fixation removal, and improves radiographic appearance and knee function during follow-up [ 18 , 19 ]. Essentially, this type of absorbable spacer is a bone graft substitute that provides support in the open wedge without rigid internal fixation; however, the longitudinal stability of the cut tibia cannot be guaranteed.…”