Comparison of closing-wedge and opening-wedge high tibial osteotomies for medial compartment osteoarthritis of knee in Asian population: Mid-term follow-up

Agarwala, Sanjay; Sobti, Anshul; Naik, Siddhant; Chaudhari, Shobhana

doi:10.1016/j.jcot.2016.06.012

Cited by 20 publications

(15 citation statements)

References 16 publications

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“…The outcomes were measured in MPTA, LDFA, and MTMA during the weight-bearing and union times. The most common complication of HTO is the lack of correction [3]. The non-locking plate is used in this study and there was no report of lack of correction after two years of follow-up.…”

Section: Discussionmentioning

confidence: 91%

“…The non-locking plate is used in this study and there was no report of lack of correction after two years of follow-up. The use of graft in previous operations with a non-locking plate has almost the same success rate with the locking plate [3]. The stability of HTO in genu varus patients depends on the type of plaque used [8][9][10][11].…”

Section: Discussionmentioning

confidence: 94%

“…Open wedge osteotomy is a technique in which there is no leg shortening or muscle separation. In closed wedge osteotomy, a bone wedge is removed from the lateral side of the bone, and plates, staples, and a tension band system are used for reconstruction [3]. In this operation, there might be some harm done to the peroneal nerve.…”

Section: Introductionmentioning

confidence: 99%

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Use of 4.5 Non-locking Plate As an Alternative Device in Open Wedge High Tibial Osteotomy for Treating Varus Deformity

Khosravi

Delbari

Bagherifard

et al. 2020

J. Res. Orthop. Sci.

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Background: High Tibial Osteotomy (HTO) is an approved surgical technique for varus knee deformity. For open wedge HTO multiple fixation methods and devices have been used. Advantages and disadvantages of these methods and devices are reported in various studies. Few studies have been conducted on use and final outcome of correction of varus knee deformity by implementation of non locking plates and benefits of this method is not fully evaluated. Objectives: To assess clinical and radiographic features of non-locking 4.5 millimeter L-buttress plate and T-buttress plate, which is used in open wedge High Tibial Osteotomy (HTO), and to find out whether this device is efficient enough or not. Methods: This cross-sectional study was conducted on 39 patients with tibial deformity recruited from a referral orthopedic hospital in Iran. Patients’ information, including their baseline characteristics, Range of Motion (ROM) of the knee, comorbidities, time of weight-bearing, union time in x-ray, graft type, and time of follow-up were reported at two stages: before and after the operation. Radiographic images were taken from their legs in both stages. Although different surgeons operated on the cases, they all used the same method. After the surgery, they were checked up in 2, 6, 12, and 24 weeks and a second alignment view was taken from the patients. Results: Thirty-nine patients underwent surgery for the correction of genu varus deformity and the follow-up time was between 6-48 months. There was no case of non-union and the ROM was perfectly restored in all the patients. Conclusion: Although the rate of the success in the use of the locking plate in HTO is higher, the use of a 4.5-mm non-locking plate seems to have decent results, too; therefore, it could be used as an alternative yet functional fixation tool in HTO.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 94%

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Use of 4.5 Non-locking Plate As an Alternative Device in Open Wedge High Tibial Osteotomy for Treating Varus Deformity

Khosravi

Delbari

Bagherifard

et al. 2020

J. Res. Orthop. Sci.

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“…As the literature has shown comparable results for both UKA and HTO [2,3], the latter has its own advantages in preserving native joints. Because of its simplicity, medial opening wedge HTO (OWHTO) has been increasingly used in recent years [4,5].…”

Section: Introductionmentioning

confidence: 99%

Risk factors of cartilage regeneration in patients who underwent high tibial osteotomy combined with microfracture

Ingle¹,

Song

Cho

et al. 2019

Preprint

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Background: One of the option for treating unicompartmental osteoarthritis (OA) is high tibial osteotomy (HTO). HTO which can shift the mechanical axis to the lateral compartment, can performed with microfracture which provides cells capable of producing cartilage. And this procedure is one of the common combinations that orthopaedic surgeons are in practice recently. The purpose of this study was to evaluate the degree of regeneration of cartilage after performing microfracture (MF) with high tibial osteotomy (HTO) after 2- year follow up and identify the factors influencing the regeneration of cartilage after the procedure. We also evaluated whether the regenerated cartilage status affects clinical outcomes. Methods: A total of 81 cases that underwent second-look arthroscopy at the time of plate removal after MF and HTO with a minimum two-year follow-up were included. The patients were divided into two groups according to femoral cartilage regeneration. Multivariable logistic regression analyses were performend to identify independent factors that influence cartilage regeneration. We also compared differences in functional outcomes between the two groups. Results: On the femoral side, grade I cartilage regeneration was found in seven (8.6%), grade II in 19 (23.5%), grade III in 26 (32.1%), and grade IV in 29 cases (35.8%), resulting in 26 (32.1%) patients belonging to well regenerated group (group A) and 55 (67.9%) to the poorly regenerated group (group B). Among factors, the size of the cartilage lesion (P=.011) and the presence of kissing lesions (P=.027) significantly affected cartilage regeneration. There were no statistically significant differences between group A and group B in terms of KSS and WOMAC scores. Conclusions: A large cartilage defect and the presence of kissing lesions are associated with poor cartilage regeneration after combined MF and HTO surgery. However, the quality of regenerated cartilage does not affect functional outcomes in patients with MF and HTO. Keywords: High tibial osteotomy, Microfracture, Second-look arthroscopy, Cartilage regeneration, risk factor

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“…The innovations, better understanding, and improvements in the surgical practices have led to better outocomes of this procedure. Agarwala et al 6 report mid term follow up of comparison of open versus closed wedge high tibial osteotomy (HTO) in medial compartment osteoarthritis (OA) and found better outcomes and functional scores with an open wedge than a closed wedge osteotomy. It corroborates with increasing trend of using open wedge osteotomy these days.…”

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confidence: 99%

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Vaishya¹,

Lal²

2016

Journal of Clinical Orthopaedics and Trauma

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Comparison of closing-wedge and opening-wedge high tibial osteotomies for medial compartment osteoarthritis of knee in Asian population: Mid-term follow-up

Cited by 20 publications

References 16 publications

Use of 4.5 Non-locking Plate As an Alternative Device in Open Wedge High Tibial Osteotomy for Treating Varus Deformity

Use of 4.5 Non-locking Plate As an Alternative Device in Open Wedge High Tibial Osteotomy for Treating Varus Deformity

Risk factors of cartilage regeneration in patients who underwent high tibial osteotomy combined with microfracture

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