Radiologic results of additional single screw fixation with lateral locking plate after hybrid closed-wedge high tibial osteotomy
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Hybrid closed-wedge high tibial osteotomy (hybrid CWHTO) is an effective surgical treatment for medial compartment osteoarthritis of the knee. Our study investigated whether the combination of a lateral locking plate and a single medial screw promoted bone union after hybrid CWHTO.The study cohort consisted of 30 patients (15 men and 15 women) who underwent hybrid CWHTO for medial compartment osteoarthritis or spontaneous osteonecrosis of the knee. Sixteen knees were fixed with a lateral locking plate (LP group), and 17 were fixed with both a lateral locking plate and a cannulated cancellous screw on the medial side of the tibia (LPS group). The times to bone union, radiolucency, and callus formation at the osteotomy site were evaluated radiographically.The mean postoperative time to radiographic confirmation of bone union was 5.5 ± 2.6 months in the LP group and 3.4 ± 1.5 months in the LPS group. Radiolucency at the osteotomy site and excess callus formation on the posterior side of the tibia were lower in the LPS group than in the LP group.This modified hybrid CWHTO combining a lateral locking plate and a cannulated cancellous screw on the medial side of the tibia improves the stability of the osteotomy site and shortens the period of bone union.
Abstract
Hybrid closed-wedge high tibial osteotomy (hybrid CWHTO) is an effective surgical treatment for medial compartment osteoarthritis of the knee. Our study investigated whether the combination of a lateral locking plate and a single medial screw promoted bone union after hybrid CWHTO.The study cohort consisted of 30 patients (15 men and 15 women) who underwent hybrid CWHTO for medial compartment osteoarthritis or spontaneous osteonecrosis of the knee. Sixteen knees were fixed with a lateral locking plate (LP group), and 17 were fixed with both a lateral locking plate and a cannulated cancellous screw on the medial side of the tibia (LPS group). The times to bone union, radiolucency, and callus formation at the osteotomy site were evaluated radiographically.The mean postoperative time to radiographic confirmation of bone union was 5.5 ± 2.6 months in the LP group and 3.4 ± 1.5 months in the LPS group. Radiolucency at the osteotomy site and excess callus formation on the posterior side of the tibia were lower in the LPS group than in the LP group.This modified hybrid CWHTO combining a lateral locking plate and a cannulated cancellous screw on the medial side of the tibia improves the stability of the osteotomy site and shortens the period of bone union.
참고문헌 (23)
- Lobenhoffer P, "Improvements in surgical technique of valgus high tibial osteotomy", Knee Surg Sports Traumatol Arthrosc, 11, pp.132~138 (2003)[DOI]
- Staubli AE, "TomoFix: a new LCPconcept for open wedge osteotomy of the medial proximal tibia--early results in 92 cases", injury, 34(Suppl 2), pp.B55~B62 (2003)[DOI]
- Hohloch L, "Customized postoperative alignment improves clinical outcome following medial open-wedge osteotomy", Knee Surg Sports Traumatol Arthrosc, 26, pp.2766~2773 (2018)[DOI]
- Jacquet C, "Opening wedge high tibial osteotomy allows better outcomes than unicompartmental knee arthroplasty in patients expecting to return to impact sports", Knee Surg Sports Traumatol Arthrosc (2020)[DOI]
- Duivenvoorden T, "Adverse events and survival after closing-and opening-wedge high tibial osteotomy : a comparative study of 412 patients", Knee Surg Sports Traumatol Arthrosc, 25, pp.895~901 (2017)[DOI]
- Otakara E, "Large deformity correction in medial open-wedge high tibial osteotomy may cause degeneration of patellofemoral cartilage : a retrospective study", Medicine(Baltimore), 98, pp.e14299~ (2019)[DOI]
- Takeuchi R, "Fractures around the lateral cortical hinge after a medial openingwedge high tibial osteotomy : a new classification of lateral hinge fracture", Arthroscopy, 28, pp.85~94 (2012)[DOI]
- Takeuchi R, "A novel closed-wedge high tibial osteotomy procedure to treat osteoarthritis of the knee : hybrid technique and rehabilitation measures", Arthrosc Tech, 3, pp.e431~ (2014)[DOI]
- Ishimatsu T, "Hybrid closed wedge high tibial osteotomy improves patellofemoral joint congruity compared with open wedge high tibial osteotomy", Knee Surg Sports Traumatol Arthrosc, 27, pp.1299~1309 (2019)[DOI]
- Takahara Y, "Time to bone union after hybrid closed-wedge high tibial osteotomy", Acta Med Okayama, 73, pp.511~516 (2019)[DOI]
- Salih S, "The callus fracture sign : a radiological predictor of progression to hypertrophic nonunion in diaphyseal tibial fractures", Strat Traum Limb Recon, 10, pp.149~153 (2015)[DOI]
- Perlepe V, "Semi-quantitative CT assessment of fracture healing : How many and which CT reformats should be analyzed?", Eur J Radiol, 118, pp.181~186 (2019)[DOI]
- Okuda M, "Validity and reliability of the Japanese Orthopaedic Association score for osteoarthritic knees", J Orthop Sci, 17, pp.750~756 (2012)[DOI]
- Hidetomo Saito, "Short-Term Results of Hybrid Closed-Wedge High Tibial Osteotomy: A Case Series with a Minimum 3-Year Follow-up", Knee Surgery and Related Research, 30(4), pp.293~302 (2018), 대한슬관절학회
- Aglietti P, "High tibial valgus osteotomy for medial gonarthrosis : a 10-to 21-year study", J Knee Surg, 16, pp.21~26 (2003)
- Naudie D, "The Install Award. Survivorship of the high tibial valgus osteotomy. A 10-to-22-year followup study", Clin Orthop Relat Res, 367, pp.18~27 (1999)
- Wu LD, "A long-term follow-up study of high tibial osteotomy for medial compartment osteoarthrosis", Chin J Traumatol, 7, pp.348~353 (2004)
- Peindl RD, "Unstable proximal extra-articular tibia fractures : a biomechanical evaluation of four methods of fixation", J Orthop Trauma, 18, pp.540~545 (2004)
- Gueorguiev-Rüegg B, "AO principles of fracture management", pp.9~26 (2018), Davos
- Claes L, "Influence of size and stability of the osteotomy gap on the success of fracture healing", J Orthop Res, 15, pp.577~584 (1997)[DOI]
- Schell H, "The course of bone healing is influenced by the initial shear fixation stability", J Orthop Res, 23, pp.1022~1028 (2005)
- Probst A, "Cellular mechanisms of bone repair", J Investig Surg, 10(3), pp.77~86 (1997)[DOI]
- Schröter S, "Early full weight-bearing versus 6-week partial weight-bearing after open wedge high tibial osteotomy leads to earlier improvement of the clinical results : a prospective, randomised evaluation", Knee Surg Sports Traumatol Arthrosc, 25, pp.325~332 (2017)[DOI]
