Hamid Reza Yazdi1, Hosein Karimi Haris2, Setareh Rohani3, Neamat Karimi4. 1. Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. 2. Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. karimi53.hosein@gmail.com. 3. Department of Physical Medicine and Rehabilitation, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 4. Department of Clinical Biochemistry, Cancer Research Laboratory, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Abstract
PURPOSE: There is no clear consensus regarding the optimal filling agent in the medial opening wedge high tibial osteotomy (MOWHTO). In this study, we evaluated the clinical and radiologic outcomes of MOWHTO with an allogeneic cancellous bone graft and TomoFix plate. METHODS: Medical profiles of 122 patients who underwent MOWHTO with cancellous bone graft from iliac crest were retrospectively reviewed. One hundred and two patients (120 knees) who met the study criteria were included in the analysis. The osteotomy site was fixed with a TomoFix plate. The mean age of the patients was 40.85 ± 22.15 years. The mean follow-up of the patients was 33.2 ± 29 months. The primary outcome measures were the union of osteotomy site and loss of correction that were investigated on postoperative radiographs. Secondary outcome measures were postoperative complications that were extracted from the patients' medical records. RESULTS: Union of the osteotomy site was observed in all patients within three months after the operation. Loss of correction at the osteotomy site occurred in two knees (1.7%), both of which underwent revision surgery. Three patients had non-infected prolonged wound drainage and underwent reoperation for allograft removal. Nine other complications were also recorded that did not require intervention, including superficial infection (n = 2), compartment syndrome (n = 1), deep vein thrombosis (n = 1), loss of knee flexion (n = 2), and transient pain at the site of the osteotomy (n = 3). CONCLUSION: Allogenic cancellous bone graft provides efficient gap healing in MOWHTO and can be used as an effective alternative to the autogenous bone graft.
PURPOSE: There is no clear consensus regarding the optimal filling agent in the medial opening wedge high tibial osteotomy (MOWHTO). In this study, we evaluated the clinical and radiologic outcomes of MOWHTO with an allogeneic cancellous bone graft and TomoFix plate. METHODS: Medical profiles of 122 patients who underwent MOWHTO with cancellous bone graft from iliac crest were retrospectively reviewed. One hundred and two patients (120 knees) who met the study criteria were included in the analysis. The osteotomy site was fixed with a TomoFix plate. The mean age of the patients was 40.85 ± 22.15 years. The mean follow-up of the patients was 33.2 ± 29 months. The primary outcome measures were the union of osteotomy site and loss of correction that were investigated on postoperative radiographs. Secondary outcome measures were postoperative complications that were extracted from the patients' medical records. RESULTS: Union of the osteotomy site was observed in all patients within three months after the operation. Loss of correction at the osteotomy site occurred in two knees (1.7%), both of which underwent revision surgery. Three patients had non-infected prolonged wound drainage and underwent reoperation for allograft removal. Nine other complications were also recorded that did not require intervention, including superficial infection (n = 2), compartment syndrome (n = 1), deep vein thrombosis (n = 1), loss of knee flexion (n = 2), and transient pain at the site of the osteotomy (n = 3). CONCLUSION: Allogenic cancellous bone graft provides efficient gap healing in MOWHTO and can be used as an effective alternative to the autogenous bone graft.
Authors: Frank R Noyes; William Mayfield; Sue D Barber-Westin; Jay C Albright; Timothy P Heckmann Journal: Am J Sports Med Date: 2006-02-21 Impact factor: 6.202