Opening Wedge High Tibial Osteotomy
- 1 August 2006
- journal article
- research article
- Published by SAGE Publications in The American Journal of Sports Medicine
- Vol. 34 (8), 1262-1273
- https://doi.org/10.1177/0363546505286144
Abstract
Background: High tibial osteotomy has been associated with significant complications, including delayed union or nonunion, loss of correction, arthrofibrosis, and patella infera. Hypotheses: A technique for opening wedge osteotomy that incorporates an autogenous iliac crest bone graft will prevent delayed union or nonunion, allow early rehabilitation and weightbearing, and prevent knee arthrofibrosis and patella infera. Secondly, the authors’ methods for calculating the desired correction of valgus alignment prevent undesired alterations in tibial slope. Study Design: Case series; Level of evidence, 4. Methods: A total of 55 consecutive patients who underwent high tibial osteotomy were observed at a mean of 20 months postoperatively. Preoperative and postoperative measurements of radiographs were conducted by independent examiners for bony union, tibial slope, and patellar height. The osteotomy opening size ranged from 5 to 17.5 mm; 35 knees (64%) had openings [.lessequal]10 mm, and 20 knees (36%) had openings >11 mm. Results: The osteotomy united in all patients. Three patients had a delay in union, which resolved by 6 to 8 months postoperatively. A loss of fixation occurred in 1 patient, who admitted to full weightbearing immediately after surgery; the osteotomy required revision. The iliac crest graft site healed without complications, and there were no infections, loss of knee motion, nerve or arterial injuries, alterations in tibial slope, or cases of patellar infera postoperatively. Full weightbearing was achieved at a mean of 8 weeks (range, 4-11 weeks) postoperatively. Conclusions: The operative technique including use of an autologous iliac crest bone graft in addition to a progressive rehabilitation program successfully prevented nonunion, change in tibial slope, and knee arthrofibrosis in this study.Keywords
This publication has 40 references indexed in Scilit:
- Chondral Resurfacing and High Tibial Osteotomy in the Varus KneeThe American Journal of Sports Medicine, 2004
- Opening Wedge High Tibial Osteotomy for Symptomatic Hyperextension-Varus ThrustThe American Journal of Sports Medicine, 2004
- Open-wedge osteotomy of the proximal tibia with hemicallotasisThe Journal of Bone and Joint Surgery, 2001
- Survivorship of the High Tibial Valgus Osteotomy A 10-to 22-Year Followup StudyPublished by Wolters Kluwer Health ,1999
- Hemicallotasis open-wedge osteotomy for osteoarthritis of the kneeThe Journal of Bone and Joint Surgery, 1999
- Preoperative Planning for High Tibial OsteotomyClinical Orthopaedics and Related Research, 1992
- The Early Diagnosis and Treatment of Developmental Patella Infera SyndromeClinical Orthopaedics and Related Research, 1991
- Proximal Tibial OsteotomyClinical Orthopaedics and Related Research, 1988
- Valgus Tibial OsteotomyPublished by Wolters Kluwer Health ,1981
- Osteoarthrosis of the KneeSouthern Medical Journal, 1973