Sanjay Agarwala1, Anshul Sobti2, Siddhant Naik1, Sameer Chaudhari1. 1. P.D. Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg Mahim, Mumbai 400016, India. 2. Darlington Memorial Hospital, County Durham & Darlington Foundation Trust, DL3 6HX, United Kingdom.
Abstract
BACKGROUND: Valgus high tibial osteotomy (HTO) is a well-established treatment option for patients with early osteoarthritis of the medial compartment of the knee. It is achievable with either open-wedge or closed-wedge technique. The aim of the study was to compare the radiological and clinical outcomes following HTO done with open- and closed-wedge techniques. MATERIAL AND METHODS: Two groups of patients undergoing HTO and fixation with locking plates were compared. Twenty-five patients were operated using medial open-wedge technique and 23 using closed-wedge technique between January 2000 and June 2014. They were compared on the basis of Hospital for Special Surgery (HSS), knee score, preoperative and postoperative range of motion, femoro-tibial angle and duration required for full-weight bearing. Early and late postoperative complications were noted. RESULTS: Median HSS score at 6 months and 1 year post-surgery was better in the open-wedge technique group. The range of motion was also higher at early follow-up in the open-wedge technique group, with shorter duration for full-weight bearing. Delayed union was seen in two patients in the open-wedge technique group and four patients in closed-wedge group. Peroneal nerve palsy was noted in two patients in the closed-wedge group. CONCLUSION: Both open-wedge and closed-wedge HTO lead to good and comparable results. However, the technique of open-wedge osteotomy provided better outcome in terms of functional scores in early as well as late follow-up with decreased duration required for full-weight bearing.
BACKGROUND:Valgus high tibial osteotomy (HTO) is a well-established treatment option for patients with early osteoarthritis of the medial compartment of the knee. It is achievable with either open-wedge or closed-wedge technique. The aim of the study was to compare the radiological and clinical outcomes following HTO done with open- and closed-wedge techniques. MATERIAL AND METHODS: Two groups of patients undergoing HTO and fixation with locking plates were compared. Twenty-five patients were operated using medial open-wedge technique and 23 using closed-wedge technique between January 2000 and June 2014. They were compared on the basis of Hospital for Special Surgery (HSS), knee score, preoperative and postoperative range of motion, femoro-tibial angle and duration required for full-weight bearing. Early and late postoperative complications were noted. RESULTS: Median HSS score at 6 months and 1 year post-surgery was better in the open-wedge technique group. The range of motion was also higher at early follow-up in the open-wedge technique group, with shorter duration for full-weight bearing. Delayed union was seen in two patients in the open-wedge technique group and four patients in closed-wedge group. Peroneal nerve palsy was noted in two patients in the closed-wedge group. CONCLUSION: Both open-wedge and closed-wedge HTO lead to good and comparable results. However, the technique of open-wedge osteotomy provided better outcome in terms of functional scores in early as well as late follow-up with decreased duration required for full-weight bearing.
Authors: T Duivenvoorden; R W Brouwer; A Baan; P K Bos; M Reijman; S M A Bierma-Zeinstra; J A N Verhaar Journal: J Bone Joint Surg Am Date: 2014-09-03 Impact factor: 5.284
Authors: Alex Schallberger; Matthias Jacobi; Peter Wahl; Gianluca Maestretti; Roland P Jakob Journal: Knee Surg Sports Traumatol Arthrosc Date: 2010-09-07 Impact factor: 4.342
Authors: Michel P J van den Bekerom; Thomas W Patt; Miriam Y Kleinhout; Harm M van der Vis; G H Rob Albers Journal: J Knee Surg Date: 2008-01 Impact factor: 2.757
Authors: Robert D A Gaasbeek; Loes Nicolaas; Willard J Rijnberg; Corne J M van Loon; Albert van Kampen Journal: Int Orthop Date: 2009-08-27 Impact factor: 3.075
Authors: Maolin Sun; Rui He; Lin Guo; Guangxing Chen; Xiaojun Duan; Ying Zhang; Liu Yang Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi Date: 2019-05-15