Effect Analysis of Opening Wedge High Tibial Osteotomy (OWHTO) for the Treatment of Medial Compartment Osteoarthritis
Journal of Surgery
Volume 7, Issue 3, June 2019, Pages: 57-62
Received: Apr. 14, 2019;
Accepted: May 21, 2019;
Published: May 30, 2019
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Songwei Huan, Department of Orthopedics, The First Affiliated Hospital, Jinan University, Guangzhou, China
Ning Liu, Department of Orthopedics, The First Affiliated Hospital, Jinan University, Guangzhou, China
Simin Luo, Department of Orthopedics, The First Affiliated Hospital, Jinan University, Guangzhou, China
Huige Hou, Department of Orthopedics, The First Affiliated Hospital, Jinan University, Guangzhou, China
Guorong She, Department of Orthopedics, The First Affiliated Hospital, Jinan University, Guangzhou, China
Tengfeng Zhuang, Department of Orthopedics, The First Affiliated Hospital, Jinan University, Guangzhou, China
Zhengang Zha, Department of Orthopedics, The First Affiliated Hospital, Jinan University, Guangzhou, China
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To investigate the clinical efficacy of open wedge high tibial osteotomy (OWHTO) in the treatment of medial compartment osteoarthritis of the knee. The authors used open OWHTO combined with TomoFix internal fixation to treat 46 cases (52 knees) with knee osteoarthritis with patella varus deformity from 2015.01 to 2017.10. HSS score and VAS score of Knee joint were used to evaluate the improvement of knee function and pain before and after surgery. The femorotibial angle (FTA), medial proximal tibial angle (MPTA), kneecap varus angle (KVA), and Weight-bearing line ratio of lower limbs (WBL) were measured by videography, which can evaluate the correction effect of postoperative knee varus. There were no happenings of internal fixation failure, delayed bone healing or non-union in these follow-up patients. At the follow-up of 3 months, 6 months, and 12 months, the HSS scores of the patients were significantly higher than those before the operation, and the difference was statistically significant (P<0.05). On March, June, and December after surgery, the HSS scores of patients were significantly higher than those before surgery and the difference was statistically significant (P<0.05). The VAS scores were lower than those before surgery, and the difference was statistically significant (P<0.05). These scores had no significant difference in the different follow-up time points (P>0.05). Imaging examination indexes showed that FTA, MPTA, KVA and WBL were improved after surgery and the varus deformity was corrected. Moreover, the difference was statistically significant (P<0.05). These scores had no significant difference in the different follow-up time points (P>0.05). In general, OWHTO can relieve joint pain and improve joint function by correcting lower limb line, showing good effect on medial compartment osteoarthritis of knee joint with varus.
High Tibial Osteotomy, Open Wedge High Tibial Osteotomy, Knee Varus Deformity, Osteoarthritis, Lower Extremity Line
To cite this article
Effect Analysis of Opening Wedge High Tibial Osteotomy (OWHTO) for the Treatment of Medial Compartment Osteoarthritis, Journal of Surgery.
Vol. 7, No. 3,
2019, pp. 57-62.
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Jackson JP and Waugh W. Tibial osteotomy for osteoarthritis of the knee. J Bone Joint Surg Br 1961; 43-b: 746-751.
van Egmond N, Stolwijk N, van Heerwaarden R, van Kampen A and Keijsers NLW. Gait analysis before and after corrective osteotomy in patients with knee osteoarthritis and a valgus deformity. Knee Surg Sports Traumatol Arthrosc 2017; 25: 2904-2913.
Collins B, Getgood A, Alomar AZ, Giffin JR, Willits K, Fowler PJ, Birmingham TB and Litchfield RB. A case series of lateral opening wedge high tibial osteotomy for valgus malalignment. Knee Surg Sports Traumatol Arthrosc 2013; 21: 152-160.
Brouwer RW, Jakma TS, Bierma-Zeinstra SM, Verhagen AP and Verhaar J. Osteotomy for treating knee osteoarthritis. Cochrane Database Syst Rev 2005; Cd004019.
Nazem K, Fouladi A and Chinigarzadeh M. Double tibial osteotomy for bow leg patients: A case series. J Res Med Sci 2013; 18: 1092-1096.
Miniaci A, Ballmer FT, Ballmer PM and Jakob RP. Proximal tibial osteotomy. A new fixation device. Clin Orthop Relat Res 1989; 250-259.
Fujisawa Y, Masuhara K and Shiomi S. The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop Clin North Am 1979; 10: 585-608.
Kumagai K, Akamatsu Y, Kobayashi H, Kusayama Y and Saito T. Mosaic Osteochondral Autograft Transplantation Versus Bone Marrow Stimulation Technique as a Concomitant Procedure With Opening-Wedge High Tibial Osteotomy for Spontaneous Osteonecrosis of the Medial Femoral Condyle. Arthroscopy 2018; 34: 233-240.
Chae DJ, Shetty GM, Wang KH, Montalban AS, Jr., Kim JI and Nha KW. Early complications of medial opening wedge high tibial osteotomy using autologous tricortical iliac bone graft and T-plate fixation. Knee 2011; 18: 278-284.
Kuremsky MA, Schaller TM, Hall CC, Roehr BA and Masonis JL. Comparison of autograft vs allograft in opening-wedge high tibial osteotomy. J Arthroplasty 2010; 25: 951-957.
Han SB, Lee DH, Shetty GM, Chae DJ, Song JG and Nha KW. A "safe zone" in medial open-wedge high tibia osteotomy to prevent lateral cortex fracture. Knee Surg Sports Traumatol Arthrosc 2013; 21: 90-95.
Hooper NM, Schouten R and Hooper GJ. The outcome of bone substitute wedges in medial opening high tibial osteotomy. Open Orthop J 2013; 7: 373-377.
Nawas HT, Vansadia DV, Heltsley JR, Suri M, Montgomery S and Jones DG. Factors Affecting the Union of Opening Wedge High Tibial Osteotomy Using a Titanium Wedge Plate. Ochsner J 2016; 16: 464-470.
Hantes ME, Natsaridis P, Koutalos AA, Ono Y, Doxariotis N and Malizos KN. Satisfactory functional and radiological outcomes can be expected in young patients under 45 years old after open wedge high tibial osteotomy in a long-term follow-up. Knee Surg Sports Traumatol Arthrosc 2018; 26: 3199-3205.
Villatte G, Erivan R, Fournier PL, Pereira B, Galvin M, Descamps S and Boisgard S. Opening-wedge high tibial osteotomy with a secure bone allograft (Osteopure) and locked plate fixation: Retrospective clinical and radiological evaluation of 69 knees after 7.5 years follow-up. Orthop Traumatol Surg Res 2015; 101: 953-957.
Zorzi AR, da Silva HG, Muszkat C, Marques LC, Cliquet A, Jr. and de Miranda JB. Opening-wedge high tibial osteotomy with and without bone graft. Artif Organs 2011; 35: 301-307.
Jacobi M, Villa V, Reischl N, Demey G, Goy D, Neyret P, Gautier E and Magnussen RA. Factors influencing posterior tibial slope and tibial rotation in opening wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 2015; 23: 2762-2768.
Darees M, Putman S, Brosset T, Roumazeille T, Pasquier G and Migaud H. Opening-wedge high tibial osteotomy performed with locking plate fixation (TomoFix) and early weight-bearing but without filling the defect. A concise follow-up note of 48 cases at 10 years' follow-up. Orthop Traumatol Surg Res 2018; 104: 477-480.
Lansdaal JR, Mouton T, Wascher DC, Demey G, Lustig S, Neyret P and Servien E. Early weight bearing versus delayed weight bearing in medial opening wedge high tibial osteotomy: a randomized controlled trial. Knee Surg Sports Traumatol Arthrosc 2017; 25: 3670-3678.
Giuseffi SA, Replogle WH and Shelton WR. Opening-Wedge High Tibial Osteotomy: Review of 100 Consecutive Cases. Arthroscopy 2015; 31: 2128-2137.
Siboni R, Beaufils P, Boisrenoult P, Steltzlen C and Pujol N. Opening-wedge high tibial osteotomy without bone grafting in severe varus osteoarthritic knee. Rate and risk factors of non-union in 41 cases. Orthop Traumatol Surg Res 2018; 104: 473-476.