Differences between opening versus closing high tibial osteotomy on clinical outcomes and gait analysis

Deie, Masataka; Hoso, Takayuki; Shimada, Norimitsu; Iwaki, Daisuke; Nakamae, Atsuo; Adachi, Nobuo; Ochi, Mitsuo

doi:10.1016/j.knee.2014.04.007

Cited by 35 publications

(36 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other studies used different standards such as IKS knee score, 18 and K/L score. 19,20 Clinical Outcomes There were no statistically significant differences in Lysholm knee score, maximal flexion, VAS (medium-short-term), VAS (long-term), HSS score, and Tegner activity score. The operation times were significantly shorter in the OWO groups as compared with the CWO groups (95% CI: À26.45, À11.41, p < 0.001) (►Table 2).…”

Section: Study Characteristics and Qualitymentioning

confidence: 90%

Comparison between Closing-Wedge and Opening-Wedge High Tibial Osteotomy in Patients with Medial Knee Osteoarthritis: A Systematic Review and Meta-analysis

Sun

Zhou

et al. 2016

J Knee Surg

View full text Add to dashboard Cite

Young active patients with medial knee osteoarthritis (OA) combined with varus leg alignment can be treated with high tibial osteotomy (HTO) to stop the progression of OA and avoid or postpone total knee arthroplasty (TKA). Closing-wedge osteotomy (CWO) and opening-wedge osteotomy (OWO) are the most commonly used osteotomy techniques. The purpose of this study was to compare the clinical and radiologic outcomes and complications between OWO and CWO. We retrospectively evaluated 23 studies including 17 clinical trials from published databases from their inception to May 2015. We evaluated the clinical outcomes including operation time, visual analog scale (VAS), maximal flexion, and hospital for special surgery knee (HSS) score. The radiologic outcomes included patellar height measured by posterior tibial slope angle, hip-knee-ankle (HKA) angle, femorotibial (FT) axis, and limb length. Complications recorded included the incidence of deep vein thrombosis (DVT), common peroneal nerve injury, opposite cortical fracture, etc. There were no differences in most of the clinical outcomes except the operation time. OWO increased the posterior slope angle and limb length, decreased the patellar height, and provided higher accuracy of correction. CWO led to a higher incidence of opposite cortical fracture.

show abstract

Section: Study Characteristics and Qualitymentioning

confidence: 90%

Comparison between Closing-Wedge and Opening-Wedge High Tibial Osteotomy in Patients with Medial Knee Osteoarthritis: A Systematic Review and Meta-analysis

Sun

Zhou

et al. 2016

J Knee Surg

View full text Add to dashboard Cite

show abstract

“…According to our literature search approaches, a total of 513 references were indexed. After excluding 487 studies for reasons specified in Fig 1 and S1 Fig , a total of 22 studies (7 RCTs and 15 non-RCTs) encompassing 2582 cases, including 1274 knees which were underwent opening-wedge HTO and 1308 ones with closing-wedge HTO operation, were finally enrolled in the final meta-analysis [ 5 – 8 , 10 , 15 – 31 ]. Table 1 listed the detailed information of recruited studies for this meta-analysis, i.e.…”

Section: Resultsmentioning

confidence: 99%

Comparison of clinical and radiological outcomes between opening-wedge and closing-wedge high tibial osteotomy: A comprehensive meta-analysis

Lin²,

Jin

et al. 2017

PLoS ONE

View full text Add to dashboard Cite

High tibial osteotomy (HTO) has been widely used for clinical treatment of osteoarthritis of the medial compartment of the knee, and both opening-wedge and closing-wedge HTO are the most commonly used methods. However, it remains unclear which technique has better clinical and radiological outcomes in practice. To systematically evaluate this issue, we conducted a comprehensive meta-analysis by pooling all available data for the opening-wedge HTO and closing-wedge HTO techniques from the electronic databases including PubMed, Embase, Wed of Science and Cochrane Library. A total of 22 studies encompassing 2582 cases were finally enrolled in the meta-analysis. There was no significant difference regarding surgery time, duration of hospitalization, knee pain VAS, Lysholm score and HSS knee score (clinical outcomes) between the opening-wedge and closing-wedge HTO groups (P > 0.05). However, the opening-wedge HTO group showed wider range of motion than the closing-wedge HTO group (P = 0.003). Moreover, as for Hip-Knee-Ankle angle and mean angle of correction, no significant difference was observed between the opening-wedge and closing-wedge HTO groups (P > 0.05), while the opening-wedge HTO group showed greater posterior tibial slope angle (P < 0.001) and lesser patellar height than the closing-wedge HTO group (P < 0.001). On light of the above analysis, we believe that individualized surgical approach should be introduced based on the clinical characteristics of each patient.

show abstract

“…Ferner et al introduced a unique algorithm for choosing between the HTO procedures, OWHTO or CWHTO, based on torsional deformity, patellar height, and length discrepancy [20]. In addition, a previous study investigating gait kinematics reported that OWHTO reduced knee varus moment and lateral thrust, whereas CWHTO had little effect on reducing lateral thrust [21]. Which HTO procedure should be selected based on the speci c situation and clinical characteristics of each patient needs to be further elucidated.…”

Section: Discussionmentioning

confidence: 99%

A comparison of clinical outcomes and cartilage repair between opening wedge and closed wedge high tibial osteotomy procedures in patients with medial osteoarthritis of the knee

Akamatsu

Kumagai

Yamada

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: The aim of the present study was to assess differences in clinical outcomes and postoperative cartilage repair between opening wedge high tibial osteotomy (OWHTO) and closed wedge HTO (CWHTO) for medial osteoarthritis (OA) of the knee.Methods: A total of 90 knees of 76 patients who underwent HTO were investigated. OWHTO was performed in 45 knees of 40 patients with a correction angle of 15° or less, and CWHTO was performed in 45 knees of 36 patients with a correction angle of greater than 15°. Initial arthroscopy was performed at the time of HTO, and a second-look arthroscopy was performed at the time of plate removal. Cartilage repair was classified into the following stages: Stage 1 (no reparative change); Stage 2 (partial coverage with white cartilaginous tissue); and Stage 3 (full coverage with white cartilaginous tissue). Clinical outcomes were assessed using Knee Society scores, and radiographic assessment was carried out by measuring the femorotibial angle (FTA).Results: Regarding preoperative OA grade, varus alignment, and function score, CWHTO patients showed more advanced OA status than OWHTO patients. Knee scores and function scores were significantly improved after surgery with both HTO procedures (P<0.05), with no significant difference between the two procedures. Cartilage repair of stage 2 or 3 was found in more than 80% of the subjects in the medial femoral condyle and more than 60% in the medial tibial condyle. However, there were no significant differences between the two HTO procedures. There was no relationship between clinical outcomes and postoperative cartilage status in both HTO procedures. Multivariate logistic regression analysis showed that preoperative International Cartilage Repair Society (ICRS) grade was the only factor affecting cartilage repair.Conclusions: CWHTO improved clinical outcomes and cartilage status as much as OWHTO. Although the effects of cartilage repair on clinical outcomes are unknown, HTO is an effective treatment option even for severe medial OA of the knee.

show abstract

Differences between opening versus closing high tibial osteotomy on clinical outcomes and gait analysis

Cited by 35 publications

References 15 publications

Comparison between Closing-Wedge and Opening-Wedge High Tibial Osteotomy in Patients with Medial Knee Osteoarthritis: A Systematic Review and Meta-analysis

Comparison between Closing-Wedge and Opening-Wedge High Tibial Osteotomy in Patients with Medial Knee Osteoarthritis: A Systematic Review and Meta-analysis

Comparison of clinical and radiological outcomes between opening-wedge and closing-wedge high tibial osteotomy: A comprehensive meta-analysis

A comparison of clinical outcomes and cartilage repair between opening wedge and closed wedge high tibial osteotomy procedures in patients with medial osteoarthritis of the knee

Contact Info

Product

Resources

About