Simultaneous bilateral opening-wedge high tibial osteotomy with structural allograft impaction results in excellent early recovery and pain reduction similar unilateral osteotomy

Neirynck, Jef; Beek, Nathalie van; Claes, Toon; Claes, Steven; Bartholomeeusen, Stijn

doi:10.1016/j.knee.2021.04.016

Cited by 6 publications

(11 citation statements)

References 25 publications

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“…Neirynck et al compared the outcome of simultaneous bilateral HTO with unilateral HTO in 29 cases and concluded that simultaneous bilateral HTO provides similar clinical outcomes as unilateral HTO and does not take an excessive amount of time to achieve these outcomes. When compared with two-staged surgery, they revealed it to be a safer and more effective treatment approach for those suffering from bilateral medial knee OA and varus alignment 22…”

Section: Discussionmentioning

confidence: 99%

Bilateral genu varum deformity correction in an adult by medial opening-wedge high tibial osteotomy without internal fixation

et al. 2022

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A young adult man in 20s presented with bow leg deformity of both the knees, since childhood and bilateral knee pain for the last 4 years. Plain radiographs of both the knees confirmed bilateral genu varum deformity, more on the right side (16.2°) as compared with left (12.3°). He was managed surgically by a single-stage bilateral medial opening wedge high tibial osteotomy, using a synthetic bone substitute of a tri calcium phosphate. After the healing of osteotomies at 3 months, the patient was pain free and walked comfortably with normal lower limb alignment.

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Section: Discussionmentioning

confidence: 99%

Bilateral genu varum deformity correction in an adult by medial opening-wedge high tibial osteotomy without internal fixation

et al. 2022

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“…Bilateral medial osteoarthritis with varus alignment is a frequently observed condition, which may require bilateral OWHTOs 6 . Simultaneous bilateral OWHTOs have advantages in fast functional recovery and medical resource saving, but with relatively high morbidity 4 .…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…Simultaneous bilateral OWHTOs have advantages in fast functional recovery and medical resource saving, but with relatively high morbidity 4 . Although staged OWHTO with long recovery intervals is safe, the advantages of simultaneous OWHTOs cannot be achieved with this time frame 1,4,6 . One-week staged bilateral OWHTOs can be a reasonable alternative considering that the one-week staged protocol is safe, and provides faster recovery, cost saving, and reduced hospital stay in the total knee arthroplasty (TKA) field 7,8 .…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…5 Bilateral medial osteoarthritis with varus alignment is a frequently observed condition, which may require bilateral OWHTOs. 6 Simultaneous bilateral OWHTOs have advantages in fast functional recovery and medical resource saving but with relatively high morbidity. 4 Although staged OWHTO with long recovery intervals is safe, the advantages of simultaneous OWHTOs cannot be achieved with this time frame.…”

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confidence: 99%

“…12,13 However, in contrast, grafts have been used to provide additional stability to the osteotomy site and prevent correction loss in simultaneous bilateral OWHTOs. 1,4,6,14 To our knowledge, no study has reported relevant outcomes about correction loss in 1week staged bilateral OWHTOs in which high loading was inevitably applied on osteotomy sites postoperatively, such as simultaneous bilateral OWHTOs, with no graft use.…”

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confidence: 99%

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Use of Grafts on an Open Gap Is Advantageous for Preventing Correction Loss in 1-Week Staged Bilateral Open-Wedge High Tibial Osteotomies

et al. 2022

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One-week staged bilateral open-wedge high tibial osteotomies (OWHTOs) can be a safe procedure, with the added advantage of fast functional recovery, cost saving, and reduced hospital stay. However, there can be concerns about correction loss after one-week staged OWHTOs because high loading is inevitably applied to osteotomy sites during postoperative weight bearing. Although leaving the osteotomy site with no grafts is possible in OWHTOs, use of grafts can provide additional stability to the osteotomy site and prevent correction loss. We compared the amount and incidence of correction loss between one-week staged bilateral OWHTOs with and without allogenic bone grafts. Seventy-five patients who underwent one-week staged bilateral OWHTOs with a locking spacer plate (Nowmedipia, Seoul, Korea) by a single surgeon were retrospectively reviewed. Allogenic cancellous bone grafts were applied in 53 patients (Group G; 106 knees, operated consecutively between 2012 and 2017), but not in 22 patients (Group N; 44 knees, operated consecutively between 2017 and 2019). Demographics were similar between the groups. Radiographically, the mechanical axis (MA), medial proximal tibial angle (MPTA), and posterior tibial slope (PTS) were evaluated preoperatively and within 1 year postoperatively. Unstable hinge fracture was investigated using computer tomography in all cases. The incidence of correction loss (MPTA loss ≥ 3°) was determined. There were no significant differences in the MA, MPTA, and PTS between the groups preoperatively and 2 weeks postoperatively. The incidence of unstable hinge fractures did not differ. The losses in MA, MPTA, and PTS during the first postoperative year were significantly greater in group N than in group G (MA, -5.5° vs. -2.3°; MPTA, -3.0° vs. 0°; PTS, -2.0° vs. -0.7°; p < 0.05° on all parameters). The correction loss incidence was 6.6% (7/106) and 31.8% (14/44) in groups G and N, respectively (p < 0.001). Appropriate treatment is necessary to prevent correction loss in one-week staged bilateral OWHTOs. Grafting, which provides additional stability to the osteotomy site, is a recommended method.

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The results of allogenic cancellous bone graft in medial opening wedge high tibial osteotomy

Yazdi

Haris²,

Rohani³

et al. 2022

Eur J Orthop Surg Traumatol

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Simultaneous bilateral opening-wedge high tibial osteotomy with structural allograft impaction results in excellent early recovery and pain reduction similar unilateral osteotomy

Cited by 6 publications

References 25 publications

Bilateral genu varum deformity correction in an adult by medial opening-wedge high tibial osteotomy without internal fixation

Bilateral genu varum deformity correction in an adult by medial opening-wedge high tibial osteotomy without internal fixation

Use of Grafts on an Open Gap Is Advantageous for Preventing Correction Loss in 1-Week Staged Bilateral Open-Wedge High Tibial Osteotomies

The results of allogenic cancellous bone graft in medial opening wedge high tibial osteotomy

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