Lack of Efficacy of Bone Void Filling Materials in Medial Opening-Wedge High Tibial Osteotomy: A Systematic Review and Network Meta-analysis

Mao, Yunhe; You, Mingke; Li, Jian; Fu, Weili

doi:10.1016/j.arthro.2022.11.039

Cited by 8 publications

(3 citation statements)

References 65 publications

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“…The osteotomy gap was filled with beta-tricalcium phosphate bone graft material. It should be noted that the use of substitution material can lead to increased pseudarthrosis rates ( 21 , 22 ) and shows no superiority for clinical scores ( 23 ) and is therefore not recommended in the opinion of the working group of this review.…”

Section: Resultsmentioning

confidence: 99%

Postoperative management following osteotomies around the knee: a narrative review

Finger,

Schröter,

Ihle

et al. 2024

EFORT Open Reviews

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The present narrative review provides a summary of postoperative therapy modalities and their effectiveness following osteotomies around the knee. The topics that are discussed in the scientific discourse include support of cartilage cell regeneration, pain management, drainage insertion, tourniquet use, pharmacological and mechanical thromboembolism prophylaxis, weight-bearing protocols and bone consolidation. There is evidence for the use of pharmacological thromboembolism prophylaxis and weight-bearing protocols. A standardized postoperative treatment concept following osteotomies around the knee cannot be derived due to lack of evidence for the other topics in current literature.

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Section: Resultsmentioning

confidence: 99%

Postoperative management following osteotomies around the knee: a narrative review

Finger,

Schröter,

Ihle

et al. 2024

EFORT Open Reviews

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show abstract

“…Therefore, there is currently no consensus on the necessity of bone grafting and the preferred choice of graft material, mostly due to the existing low certainty level of evidence in this field. 18 Therefore, the objectives of this study were twofold: (i) to compare the outcomes of bone union, patient-reported scores, and the incidence of complications in patients undergoing MOWHTO with an opening gap larger than 10 mm using autograft, allograft, or no graft at 1 year postoperatively; and (ii) to determine whether the width of the opening gap is associated with differences in mean bone union score. The hypotheses of the present study were (i) autografts would lead to better bone union outcomes but would not significantly improve functional outcomes or reduce the incidence of complications; and (ii) there would be a negative correlation between the width of the opening gap and the bone union score.…”

Section: Introductionmentioning

confidence: 99%

“…In contrast, Sasaki et al 17 reported that b‐tricalcium phosphate significantly enhances bone formation and recommended using synthetic bone void fillers. Therefore, there is currently no consensus on the necessity of bone grafting and the preferred choice of graft material, mostly due to the existing low certainty level of evidence in this field 18 …”

Section: Introductionmentioning

confidence: 99%

No Superior Bone Union Outcomes with Allografts Compared to No Grafts and Autografts Following Medial Opening Wedge High Tibial Osteotomy: A Retrospective Cohort Study

Mao,

Yao,

et al. 2023

Orthopaedic Surgery

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ObjectiveThere has been long‐standing debate about whether a medial opening wedge high tibial osteotomy (MOWHTO) gap should be filled with autologous bone graft or any other filler to expedite the healing process. The main purpose of this study was to compare the clinical and radiological outcomes of MOWHTO with an opening gap ≥10 mm, utilizing autograft, allograft, or no graft at 1 year postoperatively.MethodsA total of 68 patients were included in this retrospective study and divided into three treatment groups: Group A (no bone graft), Group B (autologous iliac crest graft), and Group C (allogenous tibia plateau graft). At postoperative 1‐year follow‐up, the area of callus filling in the most medial side of the knee was measured using anteroposterior radiographs, and a modified van Hemert scoring system was used to evaluate bone union outcomes in five mediolaterally divided zones. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores and relevant complications were assessed. The correlations between the gap width and bone union scores were evaluated.ResultsPatients in the autograft group demonstrated better bone union progression (p = 0.031) and higher bone union scores (p < 0.01) compared to patients in the allograft or no graft groups. There were no significant differences in terms of postoperative WOMAC scores and incidence of complications among the three groups. No discernible linear relationships between the width of the opening gap and the bone union score were found.ConclusionFor MOWHTOs with an average gap opening width of 12.1 mm, autografts resulted in superior bone union outcomes compared to allografts and no graft at 1 year postoperatively. However, no bone graft achieved similar outcomes to allografts, suggesting that routine use of allografts should not be recommended.

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Equal rates of bone healing and reduced surgical time with iliac crest allograft compared to autograft in medial opening wedge high tibial osteotomy: a randomized controlled clinical trial

de Paula,

Pires e Albuquerque,

de Paula Mozella

et al. 2024

Arch Orthop Trauma Surg

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Lack of Efficacy of Bone Void Filling Materials in Medial Opening-Wedge High Tibial Osteotomy: A Systematic Review and Network Meta-analysis

Cited by 8 publications

References 65 publications

Postoperative management following osteotomies around the knee: a narrative review

Postoperative management following osteotomies around the knee: a narrative review

No Superior Bone Union Outcomes with Allografts Compared to No Grafts and Autografts Following Medial Opening Wedge High Tibial Osteotomy: A Retrospective Cohort Study

Equal rates of bone healing and reduced surgical time with iliac crest allograft compared to autograft in medial opening wedge high tibial osteotomy: a randomized controlled clinical trial

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