Locking plate versus non-locking plate in open-wedge high tibial osteotomy: a meta-analysis

Han, Jae Hwi; Kim, Hyun Jung; Song, Jae Gwang; Yang, Jae Hyuk; Nakamura, Ryuichi; Shah, Daivesh; Park, Young Jee; Nha, Kyung Wook

doi:10.1007/s00167-015-3850-y

Cited by 42 publications

(22 citation statements)

References 27 publications

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“…In contrast, several studies showed that OWHTO provided higher accuracy of correction than CWHTO [ 32 , 33 ]. There may be several reasons for the controversy about accuracy between the two HTOs, including differences in osteotomy technique, fixation device, and correction angle [ 11 , 34 – 36 ]. The present results showed that there was no significant difference in postoperative lower limb alignment between CWHTO and OWHTO, although there was a discrepancy in the preoperative planning with the same correction angle.…”

Section: Discussionmentioning

confidence: 99%

Relationship between the bony correction angle and mechanical axis change and their differences between closed and open wedge high tibial osteotomy

Ogino

Kumagai

Yamada

et al. 2020

BMC Musculoskelet Disord

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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) between 2011 and 2015 with a clinical follow-up for 1 year and a radiological follow-up for 1 month were investigated in a case control study. Anteroposterior radiographs of the knee and full-length leg were taken in the standing position using digital acquisition. 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 using a dedicated software. Results CWHTO resulted in a greater variation between the tibial anatomical and mechanical axes than OWHTO (P < 0.05), and a greater soft tissue correction than OWHTO (P < 0.05). However, no significant difference was found between CWHTO and OWHTO in the ratio of MAD change to the correction angle. When the osteotomy was planned with the same bony correction angle, %MAD 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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Section: Discussionmentioning

confidence: 99%

Relationship between the bony correction angle and mechanical axis change and their differences between closed and open wedge high tibial osteotomy

Ogino

Kumagai

Yamada

et al. 2020

BMC Musculoskelet Disord

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“…Achieving appropriate postoperative realignment is crucial . The rate of postoperative failure such as loss of correction decreased with the development of an internal fixation device . However, intraoperative correction errors still occur.…”

mentioning

confidence: 99%

“…5,6 The rate of postoperative failure such as loss of correction decreased with the development of an internal fixation device. [7][8][9] However, intraoperative correction errors still occur. One example is an increase in posterior tibial slope (PTS), which has various adverse effects on knee biomechanics.…”

mentioning

confidence: 99%

Clinical efficacy of preoperative 3D planning for reducing surgical errors during open‐wedge high tibial osteotomy

Kuriyama

Morimoto²,

Shimoto

et al. 2019

Journal Orthopaedic Research

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Increases in posterior tibial slope (PTS) with open‐wedge high tibial osteotomy (OWHTO) are often related to two surgical errors: Symmetric opening of the osteotomy gap and a tendency to open the gap from the anteromedial direction. The study objective was to define trends in these two errors using computer simulation and clinical effects of their countermeasures. First, 60 knees with varus deformity were assessed with three‐dimensional (3D) planning using computed tomography to allow for the mechanical axis to pass through a point at 62.5% of the width of the tibial plateau, defined as the weight‐bearing line percentage (WBL%). Anterior and posterior widths of the opening gap to maintain PTS were measured. The effect on PTS when osteotomy gaps were opened from the anteromedial direction up to 30° was evaluated. Mean anterior width (y) was 6.6 mm (range, 2.2–10.9) and mean posterior width (x) was 9.1 mm (range, 3.9–15.7), which can be expressed as y = 0.75x − 0.24. Opening gaps from the anteromedial direction at 10°, 20°, and 30° led to a mean PTS increase of 1.9°, 3.9°, and 5.6°, respectively. In most cases, WBL% with anteromedial opening at 30° passed through a point at less than 60%. In 47 knees that underwent OWHTO using 3D planning, postoperative coronal and sagittal bone corrections were mostly accurate. However, postoperative WBL% was negatively correlated with correction angle because of difficulties in predicting medial joint tightness. Preoperative 3D planning for OWHTO can reduce surgical errors, but postoperative WBL% remains variable. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res

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“…Predominant limitations of this approach include violation of the proximal tibiofibular joint and anterior extensor compartment, risk of peroneal nerve injury, loss of proximal tibial bone stock, and a more difficult conversion to total knee arthroplasty (TKA). 5,6 Medial opening wedge (MOW) HTO has demonstrated comparable efficacy in realigning the limb to unload the affected medial compartment, with lower complication rates. Correspondingly, it has become the procedure of choice for many surgeons.…”

mentioning

confidence: 99%

“…The advantages of this procedure over LCW osteotomy include avoiding the tibiofibular joint and peroneal nerve, maintaining proximal tibial bone stock, and easier conversion to TKA. 5,6 The biggest concern with the MOW HTO is the potential for loss of correction as well as the risk of nonunion. 7 Both of these issues demand rigid fixation to maintain the correction and allow appropriate healing.…”

mentioning

confidence: 99%

Implant Alternatives for Tibial Osteotomies

Degen

Getgood

2017

J Knee Surg

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Tibial osteotomies have commonly been used to treat varus malalignment with associated medial compartment degeneration. Initially, lateral closing wedge osteotomies were commonly used. However, with the advent of improved plate osteosynthesis techniques, medial opening wedge osteotomies have become the mainstay of treatment. Presently, there are several available fixation devices, with no clear consensus on which represents the superior option. This article will serve to review the technological evolution of tibial osteotomy fixation devices, highlighting the comparative biomechanical evidence of available constructs.

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Locking plate versus non-locking plate in open-wedge high tibial osteotomy: a meta-analysis

Abstract: IV.

Cited by 42 publications

References 27 publications

Relationship between the bony correction angle and mechanical axis change and their differences between closed and open wedge high tibial osteotomy

Relationship between the bony correction angle and mechanical axis change and their differences between closed and open wedge high tibial osteotomy

Clinical efficacy of preoperative 3D planning for reducing surgical errors during open‐wedge high tibial osteotomy

Implant Alternatives for Tibial Osteotomies

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