Open-wedge osteotomy of the proximal tibia with hemicallotasis

Abstract

Conventional high tibial osteotomy for losteoarthritis of the medial compartment of the knee with closed-wedge or dome osteotomy (DMO) may produce shortening of the patellar tendon and loss of inclination of the proximal tibial plateau or of the offset of the tibial condyle relative to its bony axis. This can make subsequent total knee arthroplasty technically demanding. We undertook a prospective study comparing these changes after DMO with those after using open-wedge osteotomy hemicallotasis (HCO). A total of 50 knees with arthritis of the medial compartment in 46 consecutive patients was randomly allocated to either DMO or HCO. There were no significant differences between the groups with regard to age, gender, femorotibial angle before operation or the angle of correction. Radiological studies showed that HCO caused little change in the length of the patellar tendon or the inclination angle of the tibial plateau, while after DMO both gradually decreased. The degree of tibial condylar offset increased in both groups, but less so in the HCO group.

Management of Osteoarthritis Knee by Graduated Open Wedge High Tibial Osteotomy in 40-60 Years Age Group Using Limb Reconstruction System: A Clinical Study

“…In this study, majority of patients had radiological union at a mean of 12 weeks (10-16) after surgery. This observation coincides pretty well with study of Nakamura et al, [19]. In this study, thrust, defined as sideways movement of the knee in the coronal plane thus indicating ligamentous laxity was present in all cases preoperative.…”

“…Females were the predominant sex as seen in a study by Nakamura et al, [19]. Obesity was the major risk factor in OA and strong association has been well established [20][21][22].…”

Modified biplanar open-wedge high tibial osteotomy with rigid locking plate to treat varus knee

“…In a direct comparison of 28 closing wedge osteotomies versus 40 dome osteotomies, the average varus alignment for each was 5.67° and 1.45°, respectively. This correlated with the subjective satisfaction scores where 42.9% patients were unhappy with the closing wedge osteotomy compared with 57.5% with the dome osteotomy with an average follow-up of 8.6 years (Nakamura et al, 2001). The reported incidence of infection approximated 1%~2% for opening wedge techniques using internal plate fixation and less than 1% for closing wedge osteotomies (Rinonapoli et al, 1998).…”

Infection prophylaxis: a prospective study in 106 patients operated on by tibial osteotomy using the hemicallotasis technique

“…Chlorhexidine has the advantages of a low toxicity, broad spectra of antimicrobial activity. Chlorhexidine together with alcohol reduces the skin micro Xora and has a residual antimicrobial activity [25]. A clinical difference of 7 days was used to detect a difference between the two doses of prophylactic antibiotics in the power calculation.…”