Primary stability of different plate positions and the role of bone substitute in open wedge high tibial osteotomy

The Knee ◽  
2017 ◽  
Vol 24 (6) ◽  
pp. 1299-1306 ◽  
Author(s):  
Ryohei Takeuchi ◽  
Jung Woon-Hwa ◽  
Hiroyuki Ishikawa ◽  
Yuichiro Yamaguchi ◽  
Katsunari Osawa ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Bone Substitute ◽  
Primary Stability ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Wedge High Tibial Osteotomy

scholarly journals The effect of plate design and fixation type on primary stability after open wedge high tibial osteotomy

2013 ◽  
Vol 60 (4) ◽  
pp. 37-41
Author(s):  
Zeljko Stepanovic ◽  
Miroslav Zivkovic ◽  
Snezana Vulovic ◽  
Srbislav Aleksandrovic ◽  
Branko Ristic
Keyword(s):  
High Tibial Osteotomy ◽  
Primary Stability ◽  
Load Resistance ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Hybrid Fixation ◽  
Initial Stiffness ◽  
Wedge High Tibial Osteotomy ◽  
The Difference ◽  
The Stability

Background: The stability of the open wedge high tibial osteotomy is dependent on an undamaged cortical hinge and design of the plate. Aims: We evaluated the primary stability of two internal fixation devices for open wedge high tibial osteotomy. Methods: Five pairs of cadaveric tibia with 10? valgus correction were stabilized with a newly designed plate with hybrid fixation and 10 mm spacer block and with conventional T plate with 10 mm spacer block. Static axial loads were applied until ultimate failure of the construct. Results: The average load at initial failure of the new plate construct was 4757.7 N compared to 3022.43 N obtained with the T plate, (p<0.01). The difference in initial stiffness of both constructs was not significant (p=0.27). The mean ultimate load at failure of the new plate construct was 5280.6 N compared to 3635.3N obtained with the T plate, (p=0.001). Conclusion: The new plate with hybrid fixation, provides substantial load resistance but similar stiffness when compared to standard T plate.

scholarly journals Novel unidirectional porous hydroxyapatite used as a bone substitute for open wedge high tibial osteotomy

2014 ◽  
Vol 25 (11) ◽  
pp. 2541-2547 ◽  
Author(s):  
Kenta Uemura ◽  
Akihiro Kanamori ◽  
Katsuya Aoto ◽  
Masashi Yamazaki ◽  
Masataka Sakane
Keyword(s):  
High Tibial Osteotomy ◽  
Bone Substitute ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Porous Hydroxyapatite ◽  
Wedge High Tibial Osteotomy

scholarly journals In vivo Histological Examination of the Graft Site 3 Years after Open-wedge High Tibial Osteotomy with Nanohydroxyapatite Augmentation

2021 ◽  
Vol 11 (10) ◽  
Author(s):  
Giorgio Princi ◽  
Marco Rossini ◽  
Fabio Marzilli ◽  
Riccardo Di Niccolo ◽  
Fabio Conteduca ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Histological Examination ◽  
Bone Substitute ◽  
Bone Biopsy ◽  
Osteotomy Site ◽  
Osteoarthritis Of The Knee ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Wedge High Tibial Osteotomy

Introduction:The open-wedge high tibial osteotomy (OWHTO) is a common technique for the treatment of medial compartmental osteoarthritis of the knee. There are many options to fill the osteotomy site gap. The autologous graft donor site morbidity can be avoided using heterologous bone grafts which represent a valid alternative. Case Presentation:This case report is about a 52-year-old male with knee osteoarthritis and varus deformity. Due to stiffness, swelling, and painful limitation during daily life activities, the patient underwent OWHTO. The osteotomy gap was filled with an equine cancellous bone wedge and nanohydroxyapatite (NHA) bone paste augmentation. After 3 years, the OWTHO was converted to total knee arthroplasty and a bone biopsy of the previous graft site was performed. The histological examination presented non-viable bone areas surrounded by viable bone without inflammatory cells, suggesting the presence of residual non-viable bone from the bone substitute graft. Conclusion:The in vivo histology of the graft site after 3 years has shown that heterologous bone is a safe and valid choice as a scaffold for bone regeneration. Augmentation with NHA bone paste achieved good osteoinduction without an inflammatory reaction and good integration of the bone substitute insert. Keywords: High tibial osteotomy, histology, heterograft.

scholarly journals Risk Factor Analysis for Infection after Medial Open Wedge High Tibial Osteotomy

2021 ◽  
Vol 10 (8) ◽  
pp. 1727
Author(s):  
Ta-Wei Liu ◽  
Chih-Hao Chiu ◽  
Alvin Chao-Yu Chen ◽  
Shih-Sheng Chang ◽  
Yi-Sheng Chan
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Multivariate Analysis ◽  
High Tibial Osteotomy ◽  
Univariate Analysis ◽  
Arthroscopic Surgery ◽  
Underlying Disease ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Wedge High Tibial Osteotomy

Background: Medial open wedge high tibial osteotomy (MOWHTO) is a well-established treatment for osteoarthritis of the medial tibiofemoral compartment. Surgical site infection (SSI) after MOWHTO is a devastating complication that may require further surgery. In this study, we aimed to identify the risk factors for infection after MOWHTO over 1 to 4 years of follow-up. Methods: Fifty-nine patients who underwent MOWHTO combined with knee arthroscopic surgery were included in this prospective study. Artificial bone grafts were used in all cases. Possible risk factors, including sex, age, body mass index (BMI), underlying disease, hospitalization length, correction angle, and surgery time, were recorded. Both univariate and multivariate analysis were used. Results: A total of 59 patients who underwent 61 operations were included. Eleven patients (18.0%) were reported to have SSI. Univariate analysis showed that smoking and diabetes mellitus were positively associated with SSI. Multivariate analysis showed that smoking and age were positively associated with SSI. Three patients (4.9%) were reported to suffer from deep SSI, requiring surgical debridement, all of whom were male smokers. Conclusion: Smoking, diabetes mellitus, and old age were identified to be possible risk factors of SSI after MOWHTO. These findings are common risk factors of SSI after orthopedic surgery according to the literature. Patient selection should be performed cautiously, and postoperative prognosis for MOWHTO should be carefully explained to patients who smoke.

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