Comparison of the impact of closing wedge versus opening wedge high tibial osteotomy on proximal tibial deformity and subsequent revision to total knee arthroplasty

Kuwashima, Umito; Tashiro, Yasutaka; Okazaki, Ken; Mizu-uchi, Hideki; Hamai, Satoshi; Murakami, Koji; Iwamoto, Yukihide

doi:10.1007/s00167-016-4074-5

Cited by 29 publications

(21 citation statements)

References 27 publications

(37 reference statements)

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“…Some authors investigated the results of TKA after closing wedge osteotomy (CWO) [10,[12][13][14][15][16]27,30,35] while others investigated the results of TKA after opening wedge osteotomy (OWO). [17,27,36] The results of TKA indicated after CWO as well after OWO are similar to the ones of primaer TKA. [9,10,11,14,16] There were no significant differences between the groups underwent TKA after CWO or OWO.…”

Section: Discussionsupporting

confidence: 67%

Comparison of total knee arthroplasty after combined high tibial osteotomy with a matched group of primary total knee arthroplasty

Papp¹,

Zsakai²,

Gömöri

2019

Eklem Hastalik Cerrahisi

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Bu çalışmada önceki kombine yüksek tibial osteotomi (KO) sonrası total diz artroplasti (TDA)'lerinin sonuçları eşleştirilmiş bir primer TDA kontrol grubununkiler ile karşılaştırıldı. Hastalar ve yöntemler: 01 Ağustos 2006-31 Aralık 2011 tarihleri arasında önceden KO geçiren 24 hastada (10 erkek, 14 kadın; ort. yaş 69.5 yıl; dağılım, 60-79 yıl) 24 ardışık çimentolu TDA uygulandı (çalışma grubu). Çalışma grubu aynı dönemde primer TDA uygulanan 24 hastalık bir kontrol grubu (10 erkek, 14 kadın; ort. yaş 69.9 yıl; dağılım, 63-79 yıl) ile karşılaştırıldı. Ameliyat öncesi ve sonrası Diz Derneği diz ve fonksiyon skoru ve hareket açıklığı belirlendi. Femorotibial açı, lateral subkondral plağa tanjan ve fibula başının üstü arasındaki mesafe, tibial kondilin transpozisyonu, patellar tendonun uzunluğu ve tibial eğim açısı ameliyat öncesinde ölçüldü. Son takipte, aynı parametreler hesaplandı ve lateral tibial kemik rezeksiyonunun miktarı belirlendi. Bulgular: Ortalama takip süresi çalışma grubunda 97 ay (dağılım, 61-124 ay) ve kontrol grubunda 97 ay (dağılım, 61-123 ay) idi. Her iki grubun TDA sağkalım oranı %100 idi. Son takipte, klinik ve radyolojik veriler açısından anlamlı farklılık yoktu. Fakat sadece rezeke edilen lateral kemik miktarı çalışma grubunda kontrol grubundan anlamlı olarak daha düşüktü. Sonuç: Planlanan düzeltmenin 10° veya daha yüksek olduğu, medial diz artrozlu genç ve aktif kişilerde TDA'nın sonuçlarını olumsuz etkilemediği görünen KO'yu önermeye devam ediyoruz. Anahtar sözcükler: Diz Derneği klinik skorlama sistemleri, eşleştirilmiş gruplar, primer total diz artroplastisi, kombine yüksek tibial osteotomi sonrası total diz artroplastisi.

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Section: Discussionsupporting

confidence: 67%

Comparison of total knee arthroplasty after combined high tibial osteotomy with a matched group of primary total knee arthroplasty

Papp¹,

Zsakai²,

Gömöri

2019

Eklem Hastalik Cerrahisi

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“…Different osteotomy techniques might influence the risk for subsequent TKA; our analysis showed that prior lateral closing wedge osteotomy also led to significantly more revisions. Comparing to opening wedge HTO, it has been reported in the conversion to TKA from closing wedge HTO, the mechanical axis might be laterally displaced and the tibial insert is more likely to impinge on endosteal cortex, hence a tibial insert with smaller stem is recommended especially in closing wedge HTO [28]. However with the development of computer assisted tibial osteotomy, some traditional difficulties, such as achieving accurate alignment and preventing unintended changes in tibial slope encountered during osteotomy can be solved with computer assisted planning and navigation [29].…”

Section: Discussionmentioning

confidence: 99%

Higher risk of revision in total knee arthroplasty after high tibial osteotomy: a systematic review and updated meta-analysis

Chen

Yang

et al. 2020

BMC Musculoskelet Disord

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Background: High tibial osteotomy is commonly performed in young patients with high activity demand. Several studies have reported outcome of HTO. The reported 10-year survival ranged from 79 to 97.6%. The reported 15-year survival ranged from 56 to 65.5%, resulting in the need for conversion to TKA. Primary TKA now provides satisfactory long-term outcome in terms of function and survival. Researches have been conducted to compare clinical outcome between primary TKA and TKA after HTO to see if TKA should be the prior treatment rather than HTO in some cases. But the results were inconsistent. This study aims to compare the risk of revision and other parameters between total knee arthroplasty after high tibial osteotomy and primary total knee arthroplasty. Methods: Searches and screens of the relevant literature were conducted, after which data were extracted and pooled analysis was performed to compare the clinical outcomes between the two groups. Results: A total of 14 studies with 144,692 cases were included. Pooled analysis showed significantly more revisions and complications, and more tibial component loosening and impingement in postoperative X-ray in the HTO-TKA group. Surgical complexity during conversion to total knee arthroplasty was summarised and listed in table. Conclusion: High tibial osteotomy offers satisfactory pain relief and functional outcome in selected patients with high activity demand. However, the need for subsequent TKA should be noted, which might be a technically challenging procedure with significantly higher risk of revision comparing to primary TKA.

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“…Lateral tibial condylar offset is created by HTO, and some transposition to the bony axis occurs. In general, CWHTO has greater lateral shift of the proximal tibia from the anatomical axis than OWHTO [9,22], which often makes it difficult to perform revision total knee arthroplasty [23]. Lateral tibial condylar offset also affects the amount of the correction angle in the different osteotomy procedures.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, the lateral cortex is retained in OWHTO. The amount of lateral shift of the proximal tibia from the anatomical axis differs between CWHTO and OWHTO [9]. That is, the effect of the same bony correction angle on mechanical axis deviation is presumed to differ between CWHTO and OWHTO.…”

Section: Introductionmentioning

confidence: 99%

The ratio of mechanical axis shift to the correction angle differs in preoperative planning, but actual postoperative alignment is comparable between opening wedge and closed wedge high tibial osteotomy

Ogino

Kumagai

Yamada

et al. 2020

Preprint

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Background The purpose of this study was to investigate the relationship between the bony correction angle and mechanical axis change and their differences between closed wedge high tibial osteotomy (CWHTO) and open wedge high tibial osteotomy (OWHTO). Methods: A total of 100 knees of 89 patients who underwent OWHTO (50 knees) or CWHTO (50 knees) were investigated. The femorotibial angle (FTA), % mechanical axis deviation (MAD), % anatomical tibial axis deviation (ATAD), % mechanical tibial axis deviation (MTAD), mechanical medial proximal tibial angle (mMPTA), and joint line convergence angle (JLCA) were measured on preoperative and postoperative radiographs. The amount of change from preoperative to postoperative in each measurement is represented as Δ. Results: CWHTO resulted in a greater increase of Δ(%MTAD - %ATAD)/ΔmMPTA than OWHTO (P<0.05), and a greater decrease of ΔJLCA/ΔmMPTA than OWHTO (P<0.05). However, no significant difference was found in the Δ%MAD/ΔmMPTA between CWHTO and OWHTO. When the osteotomy was planned with the same bony correction angle, %MA passed more laterally in OWHTO than in CWHTO (P<0.05). These results suggested a lesser valgus bony correction ratio due to greater medial shift of the tibial axis and greater valgus compensation of the soft tissue in CWHTO compared to OWHTO. Conclusions: The ratio of mechanical axis shift to the correction angle differed in preoperative planning, but postoperative alignment was comparable between opening wedge and closed wedge high tibial osteotomy.

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Comparison of the impact of closing wedge versus opening wedge high tibial osteotomy on proximal tibial deformity and subsequent revision to total knee arthroplasty

Abstract: II.

Cited by 29 publications

References 27 publications

Comparison of total knee arthroplasty after combined high tibial osteotomy with a matched group of primary total knee arthroplasty

Comparison of total knee arthroplasty after combined high tibial osteotomy with a matched group of primary total knee arthroplasty

Higher risk of revision in total knee arthroplasty after high tibial osteotomy: a systematic review and updated meta-analysis

The ratio of mechanical axis shift to the correction angle differs in preoperative planning, but actual postoperative alignment is comparable between opening wedge and closed wedge high tibial osteotomy

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