Bone Healing and Clinical Outcome Following Medial Opening‐wedge High Tibial Osteotomy Using Wedge‐Shaped Cancellous Allograft
Objective Medial opening‐wedge high tibial osteotomy (MOWHTO) is considered to be an effective treatment for symptomatic knee osteoarthritis (KOA) of isolated the medial compartment with varus alignment of the lower extremity. However, the choice of material to fill the void remains controversial. T...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-01-01
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| Series: | Orthopaedic Surgery |
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| Online Access: | https://doi.org/10.1111/os.13939 |
| _version_ | 1827383790472790016 |
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| author | Jinlun Chen Jiahao Li Haitao Zhang Wenjun Feng Pengcheng Ye Xinyu Qi Jie Li Peng Deng Yijin Li Yiwei Huang Jianchun Zeng Yirong Zeng |
| author_facet | Jinlun Chen Jiahao Li Haitao Zhang Wenjun Feng Pengcheng Ye Xinyu Qi Jie Li Peng Deng Yijin Li Yiwei Huang Jianchun Zeng Yirong Zeng |
| author_sort | Jinlun Chen |
| collection | DOAJ |
| description | Objective Medial opening‐wedge high tibial osteotomy (MOWHTO) is considered to be an effective treatment for symptomatic knee osteoarthritis (KOA) of isolated the medial compartment with varus alignment of the lower extremity. However, the choice of material to fill the void remains controversial. This study aims to evaluate the bone union of the osteotomy gap using a novel wedge‐shaped cancellous allograft after MOWHTO and its effect on clinical outcomes. Methods All patients who underwent MOWHTO using a novel wedge‐shaped cancellous allograft combined with TomoFix locking compression plate (LCP) fixation between January 2016 and July 2020 were enrolled. The radiographic parameters including hip‐knee‐ankle angle (HKAA), medial proximal tibial angle (MPTA), femorotibial angle (FTA) and posterior tibial slope angle (PTSA) were measured between pre‐operative and post‐operative radiographs. Knee Society score (KSS) and range of motion (ROM) were assessed preoperatively and at last follow‐up. Patients included in this study were divided into two groups according to the correction angle: small correction group (< 10°; SC group) and large correction group (≥ 10°; LC group). The modified Radiographic Union score for tibial fractures (mRUST) was used to assess the difference in bone healing between the two groups at 1, 3, 6, and 12 months postoperatively and at the final follow‐up. A paired student's t test was conducted for comparison of differences of the relevant data pre‐operatively and post‐operatively. Results A total of 82 patients (88 knees) were included in this study. The HKAA, MPTA, FTA and PTSA increased from −6.4° ± 3.0°, 85.1° ± 2.6°, 180.1° ± 3.2° and 7.7° ± 4.4° preoperatively to 1.2° ± 4.3° (p < 0.001), 94.4° ± 3.3° (p < 0.001), 171.0° ± 2.8° and 11.8° ± 5.8° (p < 0.001) immediately postoperatively, respectively. However, no significant statistic difference was found in above‐mentioned parameters at last follow‐up compared to immediate postoperative data (p > 0.05). All patients in this study achieved good bone healing at the final follow‐up and no significant differences in mRUST scores were seen between the SC group and LC group. The KSS‐Knee score and KSS‐Function score improved significantly from 55.4 ± 3.7 and 63.3 ± 4.6 preoperatively to 86.4 ± 2.8 (p < 0.001) and 89.6 ± 2.9 (p < 0.001) at last follow‐up, respectively. Nevertheless, there was no significant difference in ROM between pre‐operation and last follow‐up (p > 0.05). Conclusion For MOWHTO, the wedge‐shaped cancellous allograft was a reliable choice for providing good bone healing and clinical outcomes. |
| first_indexed | 2024-03-08T14:46:26Z |
| format | Article |
| id | doaj.art-e39ad5bdadb34e8a998afcf3ccf664a7 |
| institution | Directory Open Access Journal |
| issn | 1757-7853 1757-7861 |
| language | English |
| last_indexed | 2024-03-08T14:46:26Z |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj.art-e39ad5bdadb34e8a998afcf3ccf664a72024-01-11T09:51:57ZengWileyOrthopaedic Surgery1757-78531757-78612024-01-01161869310.1111/os.13939Bone Healing and Clinical Outcome Following Medial Opening‐wedge High Tibial Osteotomy Using Wedge‐Shaped Cancellous AllograftJinlun Chen0Jiahao Li1Haitao Zhang2Wenjun Feng3Pengcheng Ye4Xinyu Qi5Jie Li6Peng Deng7Yijin Li8Yiwei Huang9Jianchun Zeng10Yirong Zeng11The First Clinical Medical College Guangzhou University of Chinese Medicine Guangzhou ChinaDepartment of Orthopaedics Panyu Hospital of Chinese Medicine Guangzhou ChinaLonghua Hospital Shanghai University of Traditional Chinese Medicine Shanghai ChinaDepartment of Orthopaedics The First Affiliated Hospital of Guangzhou University of Chinese Medicine Guangzhou ChinaDepartment of Orthopaedics The First Affiliated Hospital of Guangzhou University of Chinese Medicine Guangzhou ChinaDepartment of Orthopaedics The First Affiliated Hospital of Guangzhou University of Chinese Medicine Guangzhou ChinaDepartment of Orthopaedics The First Affiliated Hospital of Guangzhou University of Chinese Medicine Guangzhou ChinaDepartment of Orthopaedics Guangdong Second Traditional Chinese Medicine Hospital Guangzhou ChinaThe First Clinical Medical College Guangzhou University of Chinese Medicine Guangzhou ChinaThe First Clinical Medical College Guangzhou University of Chinese Medicine Guangzhou ChinaDepartment of Orthopaedics The First Affiliated Hospital of Guangzhou University of Chinese Medicine Guangzhou ChinaDepartment of Orthopaedics The First Affiliated Hospital of Guangzhou University of Chinese Medicine Guangzhou ChinaObjective Medial opening‐wedge high tibial osteotomy (MOWHTO) is considered to be an effective treatment for symptomatic knee osteoarthritis (KOA) of isolated the medial compartment with varus alignment of the lower extremity. However, the choice of material to fill the void remains controversial. This study aims to evaluate the bone union of the osteotomy gap using a novel wedge‐shaped cancellous allograft after MOWHTO and its effect on clinical outcomes. Methods All patients who underwent MOWHTO using a novel wedge‐shaped cancellous allograft combined with TomoFix locking compression plate (LCP) fixation between January 2016 and July 2020 were enrolled. The radiographic parameters including hip‐knee‐ankle angle (HKAA), medial proximal tibial angle (MPTA), femorotibial angle (FTA) and posterior tibial slope angle (PTSA) were measured between pre‐operative and post‐operative radiographs. Knee Society score (KSS) and range of motion (ROM) were assessed preoperatively and at last follow‐up. Patients included in this study were divided into two groups according to the correction angle: small correction group (< 10°; SC group) and large correction group (≥ 10°; LC group). The modified Radiographic Union score for tibial fractures (mRUST) was used to assess the difference in bone healing between the two groups at 1, 3, 6, and 12 months postoperatively and at the final follow‐up. A paired student's t test was conducted for comparison of differences of the relevant data pre‐operatively and post‐operatively. Results A total of 82 patients (88 knees) were included in this study. The HKAA, MPTA, FTA and PTSA increased from −6.4° ± 3.0°, 85.1° ± 2.6°, 180.1° ± 3.2° and 7.7° ± 4.4° preoperatively to 1.2° ± 4.3° (p < 0.001), 94.4° ± 3.3° (p < 0.001), 171.0° ± 2.8° and 11.8° ± 5.8° (p < 0.001) immediately postoperatively, respectively. However, no significant statistic difference was found in above‐mentioned parameters at last follow‐up compared to immediate postoperative data (p > 0.05). All patients in this study achieved good bone healing at the final follow‐up and no significant differences in mRUST scores were seen between the SC group and LC group. The KSS‐Knee score and KSS‐Function score improved significantly from 55.4 ± 3.7 and 63.3 ± 4.6 preoperatively to 86.4 ± 2.8 (p < 0.001) and 89.6 ± 2.9 (p < 0.001) at last follow‐up, respectively. Nevertheless, there was no significant difference in ROM between pre‐operation and last follow‐up (p > 0.05). Conclusion For MOWHTO, the wedge‐shaped cancellous allograft was a reliable choice for providing good bone healing and clinical outcomes.https://doi.org/10.1111/os.13939Bone allograftBone healingHigh tibial osteotomy |
| spellingShingle | Jinlun Chen Jiahao Li Haitao Zhang Wenjun Feng Pengcheng Ye Xinyu Qi Jie Li Peng Deng Yijin Li Yiwei Huang Jianchun Zeng Yirong Zeng Bone Healing and Clinical Outcome Following Medial Opening‐wedge High Tibial Osteotomy Using Wedge‐Shaped Cancellous Allograft Orthopaedic Surgery Bone allograft Bone healing High tibial osteotomy |
| title | Bone Healing and Clinical Outcome Following Medial Opening‐wedge High Tibial Osteotomy Using Wedge‐Shaped Cancellous Allograft |
| title_full | Bone Healing and Clinical Outcome Following Medial Opening‐wedge High Tibial Osteotomy Using Wedge‐Shaped Cancellous Allograft |
| title_fullStr | Bone Healing and Clinical Outcome Following Medial Opening‐wedge High Tibial Osteotomy Using Wedge‐Shaped Cancellous Allograft |
| title_full_unstemmed | Bone Healing and Clinical Outcome Following Medial Opening‐wedge High Tibial Osteotomy Using Wedge‐Shaped Cancellous Allograft |
| title_short | Bone Healing and Clinical Outcome Following Medial Opening‐wedge High Tibial Osteotomy Using Wedge‐Shaped Cancellous Allograft |
| title_sort | bone healing and clinical outcome following medial opening wedge high tibial osteotomy using wedge shaped cancellous allograft |
| topic | Bone allograft Bone healing High tibial osteotomy |
| url | https://doi.org/10.1111/os.13939 |
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