Biplanar Medial Open-Wedge High Tibial Osteotomy for Medial Compartment Osteoarthritis of the Knee: A Novel Technique and Follow-Up

2007 ◽  
Vol 17 (1) ◽  
pp. 29-37 ◽  
Author(s):  
Sung-Jae Kim ◽  
Ravindra H. Mahajan ◽  
Kwang-Yeoul Park ◽  
Tae-Eun Kim ◽  
Doo-Hyung Lee ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Medial Compartment ◽  
Osteoarthritis Of The Knee ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Medial Compartment Osteoarthritis ◽  
Novel Technique ◽  
Wedge High Tibial Osteotomy

The Outcome of Tricalcium Phosphate Wedges Used in Opening High Tibial Osteotomy

2016 ◽  
Vol 695 ◽  
pp. 139-143
Author(s):  
Ioan Cristescu ◽  
Cristi Angheluta ◽  
Florin Safta ◽  
Daniel Vilcioiu ◽  
Alsed Gjoni ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Tricalcium Phosphate ◽  
Bone Substitutes ◽  
Medial Compartment ◽  
Wedge Osteotomy ◽  
Osteoarthritis Of The Knee ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Medial Compartment Osteoarthritis ◽  
Wedge High Tibial Osteotomy

In the case of patients suffering from medial compartment osteoarthritis of the knee, a high tibial osteotomy is the preferred treatment for preserving the knee articulation and correcting the knee biomechanical axis. Nowadays, the open wedge high tibial osteotomy is the preferred surgical technique for treating patient with varus knee angulation. The procedure consists in creating a medial gap in the proximal tibial metaphysis that is filled with autologus bone graft or bone substitutes. Synthetic bone substitutes made by bioceramics like hydroxyapatite or tricalcium phosphate are becoming more popular. Tricalcium phosphate (TCP) used as a bone substitute has shown to have osteoconductive properties and it is resorbable. We describe our experience in Orthopaedics III Department of the Clinical Emergency Hospital Bucharest, where we treated a total of 26 patients suffering from medial compartment osteoarthritis of the knee with high tibial open wedge osteotomy, between 2011 and 2015. TCP wedge implants were successfully used as bone substitutes for the tibial medial osteotomy in conjunction with a proximal tibia plate and screws. Open wedge high tibia osteotomy used for correcting the biomechanical axis of the lower limb is a safe surgical procedure that preserves the anatomical knee joint.

scholarly journals Impact of medial open-wedge high tibial osteotomy for medial compartment osteoarthritis of the knee

2020 ◽  
Vol 11 (12) ◽  
pp. 606-614
Author(s):  
Sunil Sheshrao Nikose ◽  
Devashree Nikose ◽  
Aditya L Kekatpure ◽  
Shashank Jain ◽  
Kiran Saoji ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Medial Compartment ◽  
Osteoarthritis Of The Knee ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Medial Compartment Osteoarthritis ◽  
Wedge High Tibial Osteotomy

scholarly journals Does postoperative quantitative bone scintigraphy reflect outcomes following medial open-wedge high tibial osteotomy?

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257315
Author(s):  
Jung-Kwon Bae ◽  
Kang-Il Kim ◽  
Jun-Ho Kim ◽  
Hyun-Gon Gwak ◽  
Chanwoo Kim
Keyword(s):  
Clinical Outcomes ◽  
High Tibial Osteotomy ◽  
Femoral Condyle ◽  
Cartilage Regeneration ◽  
Medial Compartment ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Postoperative Changes ◽  
Wedge High Tibial Osteotomy

Purpose The present study evaluated changes in bone tracer uptake (BTU) after medial open-wedge high tibial osteotomy (MOWHTO) and determined whether postoperative BTU correlates with clinical symptoms, radiologic parameters, or cartilage regeneration following MOWHTO. Methods A total of 210 knees underwent MOWHTO for medial compartmental osteoarthritis (OA) were enrolled in this study. Mean follow-up period was 42.7 months. We assessed BTU for the medial compartment of the knee before MOWHTO and at the time of plate removal. Radiologic parameters included Kellgren-Lawrence (K-L) grade and Hip-Knee-Ankle angle (HKAA). Clinical evaluation included American Knee Society (AKS) score and cartilage status was graded at the time of MOWHTO and second-look arthroscopy according to the International Cartilage Repair Society (ICRS) grading system and articular cartilage regeneration stage. Statistical analysis performed to assess the relationships among postoperative BTU of the medial compartment, radiologic parameters, arthroscopic changes and clinical outcomes. Results BTU of medial femoral condyle and tibial plateau were significantly decreased at 2 years after MOWHTO (p<0.001). AKS scores and arthroscopic cartilage status were also significantly improved following MOWHTO. BMI and postoperative HKAA showed significant correlations with postoperative changes of BTU in uni- and multi-variable analysis. Meanwhile, postoperative changes of BTU did not show significant correlation with clinical outcomes or cartilage regeneration following MOWHTO. Conclusion Lower BMI and postoperative valgus alignment were significant predictor for postoperative BTU decrease of the medial compartment following MOWHTO. However, postoperative changes of BTU did not reflect cartilage regeneration or clinical outcomes until the midterm follow-up.

The Fate of Bone Marrow Lesions After Open Wedge High Tibial Osteotomy: A Comparison Between Knees With Primary Osteoarthritis and Subchondral Insufficiency Fractures

2021 ◽  
pp. 036354652110021
Author(s):  
Han Gyeol Choi ◽  
Joo Sung Kim ◽  
Hyun Jin Yoo ◽  
You Sun Jung ◽  
Yong Seuk Lee
Keyword(s):  
Bone Marrow ◽  
High Tibial Osteotomy ◽  
Insufficiency Fracture ◽  
Tibial Osteotomy ◽  
Pathological Feature ◽  
Open Wedge ◽  
Varus Malalignment ◽  
Bone Marrow Lesions ◽  
Wedge High Tibial Osteotomy

Background: Subchondral insufficiency fracture of the knee (SIFK) is characterized by a subchondral lesion that may lead to end-stage osteoarthritis (OA). In patients who have SIFK in a precollapse state with varus malalignment, a joint-preserving technique such as open wedge high tibial osteotomy (OWHTO) should be considered. Purpose: To evaluate the efficacy of OWHTO in primary OA and SIFK-dominant OA by clinical and radiological evaluations including magnetic resonance imaging (MRI). Study Design: Cohort study; Level of evidence 3. Methods: A total of 33 SIFK-dominant OA knees and 66 with primary OA that underwent biplanar OWHTO between March 2014 and February 2016 were included after 1:2 propensity score matching. The MRI Osteoarthritis Knee Score was used to assess bone marrow lesions (BMLs) preoperatively and at follow-up. The weightbearing line ratio, the hip-knee-ankle angle, and the joint line convergence angle were measured. The clinical outcomes assessed were range of motion, the American Knee Society Score, and the Western Ontario and McMaster University (WOMAC) score. Results: The mean follow-up period was 41.2 ± 12.6 months. The distribution of preoperative BML grade in the SIFK-dominant OA group was significantly higher in both the femur and tibia ( P < .001 and <.001, respectively) than that in the primary OA group. However, the difference was not significant postoperatively (femur, P = .425; tibia, P = .462). In both groups, postoperative BMLs showed significant improvement compared with preoperative BMLs (primary OA [femur, P < .001; tibia, P = .001] and SIFK-dominant OA [femur, P < .001; tibia, P < .001]). The WOMAC pain score was higher in the SIFK-dominant OA group preoperatively (primary OA, 7.0 ± 3.73; SIFK-dominant OA, 9.17 ± 2.6; P = .032) even though it was not different at the final follow-up (primary OA, 2.11 ± 1.7; SIFK-dominant OA, 1.79 ± 1.32; P = .179). Conclusion: OWHTO is an effective procedure not only for primary OA but also for SIFK-dominant OA. OWHTO can improve BMLs, which represent the main pathological feature of SIFK. Therefore, in patients who have SIFK with varus malalignment, OWHTO can be an attractive treatment option for preserving the joint and enhancing subchondral bone healing.

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