Is Bone Grafting Necessary in Opening Wedge High Tibial Osteotomy? A Meta-Analysis of Radiological Outcomes
1
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Purpose: Bone grafting in opening wedge high tibial osteotomy (OWHTO) is still controversial. The purpose of this study is to compare the radiological outcomes of OWHTO with bone graft (autogenous, allogenous, and synthetic bone graft) and those without bone graft. Materials and Methods: PubMed, MEDLINE, EMBASE and Cochrane Register of Studies databases were searched using specific inclusion and exclusion criteria for radiological studies involving OWHTO with bone graft and without bone graft groups. All reported delayed union, nonunion and correction loss were analyzed. Data were searched from the time period of January 2000 through July 2014. In addition, a modified Coleman methodology score (CMS) system was used to assess the methodological quality of the included studies. Results: Twenty-five studies with a mean CMS value of 77 (range, 61 to 85 score) were included. In total, 1,841 patients underwent OWHTO using 4 different procedures for bone graft: autobone graft (n=352), allobone graft (n=547), synthetic bone graft (n=541) and no bone graft (n=401). There was a similar tendency for delayed union, nonunion and correction loss rate among the osteotomy space filling methods.Conclusions: The meta-analysis showed there was a similar tendency for radiological union and correction maintenance among patients undergoing OWHTO regardless of the type of bone in all of the studies. However, the currently available evidence is not sufficient to strongly support the superiority of OWHTO with bone graft to OWHTO without bone graft.
Abstract
Purpose: Bone grafting in opening wedge high tibial osteotomy (OWHTO) is still controversial. The purpose of this study is to compare the radiological outcomes of OWHTO with bone graft (autogenous, allogenous, and synthetic bone graft) and those without bone graft. Materials and Methods: PubMed, MEDLINE, EMBASE and Cochrane Register of Studies databases were searched using specific inclusion and exclusion criteria for radiological studies involving OWHTO with bone graft and without bone graft groups. All reported delayed union, nonunion and correction loss were analyzed. Data were searched from the time period of January 2000 through July 2014. In addition, a modified Coleman methodology score (CMS) system was used to assess the methodological quality of the included studies. Results: Twenty-five studies with a mean CMS value of 77 (range, 61 to 85 score) were included. In total, 1,841 patients underwent OWHTO using 4 different procedures for bone graft: autobone graft (n=352), allobone graft (n=547), synthetic bone graft (n=541) and no bone graft (n=401). There was a similar tendency for delayed union, nonunion and correction loss rate among the osteotomy space filling methods.Conclusions: The meta-analysis showed there was a similar tendency for radiological union and correction maintenance among patients undergoing OWHTO regardless of the type of bone in all of the studies. However, the currently available evidence is not sufficient to strongly support the superiority of OWHTO with bone graft to OWHTO without bone graft.
참고문헌 (49)
- Niemeyer P, "Two-year results of open-wedge high tibial osteotomy with fixation by medial plate fixator for medial compartment arthritis with varus malalignment of the knee", Arthroscopy, 24, pp.796~804 (2008)
- Staubli AE, "TomoFix: a new LCP-concept for open wedge osteotomy of the medial proximal tibia: early results in 92 cases", Injury, 34(Suppl 2), pp.B55~B62 (2003)
- Lobenhoffer P, "Improvements in surgical technique of valgus high tibial osteotomy", Knee Surg Sports Traumatol Arthrosc, 11, pp.132~138 (2003)
- Akizuki S, "The long-term outcome of high tibial osteotomy : a ten-to 20-year follow-up", J Bone Joint Surg Br, 90, pp.592~596 (2008)
- Chae DJ, "Early complications of medial opening wedge high tibial osteotomy using autologous tricortical iliac bone graft and T-plate fixation", Knee, 18, pp.278~284 (2011)
- Ahlmann E, "Comparison of anterior and posterior iliac crest bone grafts in terms of harvest-site morbidity and functional outcomes", J Bone Joint Surg Am, 84, pp.716~720 (2002)
- Yacobucci GN, "Union of medial opening-wedge high tibial osteotomy using a corticocancellous proximal tibial wedge allograft", Am J Sports Med, 36, pp.713~719 (2008)
- Lobenhoffer P, "Open valgus alignment osteotomy of the proximal tibia with fixation by medial plate fixator", Orthopade, 33, pp.153~160 (2004)
- Niemeyer P, "Open-wedge osteotomy using an internal plate fixator in patients with medial-compartment gonarthritis and varus malalignment : 3-year results with regard to preoperative arthroscopic and radiographic findings", Arthroscopy, 26, pp.1607~1616 (2010)
- Zorzi AR, "Opening-wedge high tibial osteotomy with and without bone graft", Artif Organs, 35, pp.301~307 (2011)
- Maier RV, "What the surgeon of tomorrow needs to know about evidence-based surgery", Arch Surg, 141, pp.317~323 (2006)
- Kral JG, "Flaws in methods of evidence-based medicine may adversely affect public health directives", Surgery, 137, pp.279~284 (2005)
- Higgins JP, "Measuring inconsistency in meta-analyses", BMJ, 327, pp.557~560 (2003)
- Moher D, "Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement", PLoS Med, 6, pp.e1000097~ (2009)
- Bode G, "Prospective 5-year survival rate data following open-wedge valgus high tibial osteotomy", Knee Surg Sports Traumatol Arthrosc, 23, pp.1949~1955 (2015)
- Schroter S, "High complication rate after biplanar open wedge high tibial osteotomy stabilized with a new spacer plate(Position HTO plate)without bone substitute", Arthroscopy, 27, pp.644~652 (2011)
- El-Azab HM, "Limb alignment after open-wedge high tibial osteotomy and its effect on the clinical outcome", Orthopedics, 34, pp.e622~e628 (2011)
- Brosset T, "Opening wedge high tibial osteotomy performed without filling the defect but with locking plate fixation(TomoFixTM)and early weight-bearing : prospective evaluation of bone union, precision and maintenance of correction in 51 cases", Orthop Traumatol Surg Res, 97, pp.705~711 (2011)
- El-Assal MA, "Opening-wedge high tibial osteotomy without bone graft", Knee Surg Sports Traumatol Arthrosc, 18, pp.961~966 (2010)
- Kolb W, "Opening-wedge high tibial osteotomy with a locked low-profile plate", J Bone Joint Surg Am, 91, pp.2581~2588 (2009)
- Zaki SH, "High tibial valgus osteotomy using the Tomofix plate : medium-term results in young patients", Acta Orthop Belg, 75, pp.360~367 (2009)
- Shim JS, "High tibial open wedge osteotomy below the tibial tubercle : clinical and radiographic results", Knee Surg Sports Traumatol Arthrosc, 21, pp.57~63 (2013)
- Schroter S, "Return to work and clinical outcome after open wedge HTO", Knee Surg Sports Traumatol Arthrosc, 21, pp.213~219 (2013)
- Noyes FR, "Opening wedge high tibial osteotomy : an operative technique and rehabilitation program to decrease complications and promote early union and function", Am J Sports Med, 34, pp.1262~1273 (2006)
- Haviv B, "Mid-term outcome of opening-wedge high tibial osteotomy for varus arthritic knees", Orthopedics, 35, pp.e192~e196 (2012)
- Santic V, "Bone allograft provides bone healing in the medial opening high tibial osteotomy", Int Orthop, 34, pp.225~229 (2010)
- DeMeo PJ, "Midterm follow-up of opening-wedge high tibial osteotomy", Am J Sports Med, 38, pp.2077~2084 (2010)
- Saito T, "Five-to ten-year outcome following medial opening-wedge high tibial osteotomy with rigid plate fixation in combination with an artificial bone substitute", Bone Joint J, 96, pp.339~344 (2014)
- Saragaglia D, "Outcome of opening wedge high tibial osteotomy augmented with a Biosorb® wedge and fixed with a plate and screws in 124 patients with a mean of ten years follow-up", Int Orthop, 35, pp.1151~1156 (2011)
- Ozalay M, "Remodeling potentials of biphasic calcium phosphate granules in open wedge high tibial osteotomy", Arch Orthop Trauma Surg, 129, pp.747~752 (2009)
- Koshino T, "Medial opening-wedge high tibial osteotomy with use of porous hydroxyapatite to treat medial compartment osteoarthritis of the knee", J Bone Joint Surg Am, 85, pp.78~85 (2003)
- Hernigou P, "Open wedge tibial osteotomy with acrylic bone cement as bone substitute", Knee, 8, pp.103~110 (2001)
- Pornrattanamaneewong C, "A retrospective analysis of medial opening wedge high tibial osteotomy for varus osteoarthritic knee", Indian J Orthop, 46, pp.455~461 (2012)
- Jung WH, "Comparative study of medial opening-wedge high tibial osteotomy using 2 different implants", Arthroscopy, 29, pp.1063~1071 (2013)
- Kuremsky MA, "Comparison of autograft vs allograft in opening-wedge high tibial osteotomy", J Arthroplasty, 25, pp.951~957 (2010)
- Gouin F, "Open wedge high tibial osteotomies : Calcium-phosphate ceramic spacer versus autologous bonegraft", Orthop Traumatol Surg Res, 96, pp.637~645 (2010)
- Aryee S, "Do we need synthetic osteotomy augmentation materials for opening-wedge high tibial osteotomy", Biomaterials, 29, pp.3497~3502 (2008)
- Gaasbeek RD, "Mechanism of bone incorporation of beta-TCP bone substitute in open wedge tibial osteotomy in patients", Biomaterials, 26, pp.6713~6719 (2005)
- Pornrattanamaneewong C, "Loss of correction after medial opening wedge high tibial osteotomy: a comparison of locking plates without bone grafts and non-locking compression plates with bone grafts", J Med Assoc Thai, 95(Suppl 9), pp.S21~S28 (2012)
- van Hemert WL, "Tricalcium phosphate granules or rigid wedge preforms in open wedge high tibial osteotomy : a radiological study with a new evaluation system", Knee, 11, pp.451~456 (2004)
- Brinkman JM, "Osteotomies around the knee : patient selection, stability of fixation and bone healing in high tibial osteotomies", J Bone Joint Surg Br, 90, pp.1548~1557 (2008)
- Roderer G, "Delayed bone healing following high tibial osteotomy related to increased implant stiffness in locked plating", Injury, 45, pp.1648~1652 (2014)
- Esenkaya I, "Proximal tibia medial open-wedge osteotomy using plates with wedges : early results in 58 cases", Knee Surg Sports Traumatol Arthrosc, 14, pp.955~961 (2006)
- Hartford JM, "Biomechanical superiority of plate fixation for proximal tibial osteotomy", Clin Orthop Relat Res, (412), pp.125~130 (2003)
- Miller BS, "The effect of lateral cortex disruption and repair on the stability of the medial opening wedge high tibial osteotomy", Am J Sports Med, 33, pp.1552~1557 (2005)
- van Raaij TM, "Opposite cortical fracture in high tibial osteotomy : lateral closing compared to the medial opening-wedge technique", Acta Orthop, 79, pp.508~514 (2008)
- Spahn G, "Factors that influence high tibial osteotomy results in patients with medial gonarthritis : a score to predict the results", Osteoarthritis Cartilage, 14, pp.190~195 (2006)
- van Houten AH, "Medial open wedge high tibial osteotomy: can delayed or nonunion be predicted?", Clin Orthop Relat Res, 472, pp.1217~1223 (2014)
- "Recommendations on testing for funnel plot asymmetry" (2011)[URL]
