Open wedge tibial osteotomy by hemicallotasis for medial compartiment osteoarthritis

Abstract

Early clinical results were evaluated for 22 adult patients who had undergone an open wedge tibial osteotomy by hemicallotasis (HCO) due to medial compartment osteoarthritis. The mean age at the time of the index operation was 56 (range 33-66) years. The mean duration of follow up was 16 (range 9-23) months. The median hip-knee-ankle angle (HKA) was 169 (range 162-186) deg preoperatively and 182 (range 175-191) deg at follow up. We did not observe any early collapse of the new bone wedge. The median time to fixation was 79 (range 63-125) days. Complications included two pintract infections, and two hematomas were revised. Two patients felt pain during the phase of distraction, but the procedure could be continued after a short break. We evaluated the clinical results on the HSS, Lysholm, and Tegner activity scores. At the latest follow up examination, all of the scores had improved. Our findings demonstrate that HCO requires an exact correction, is a simple technique, and appears to reduce the chance of nerve and vascular damage.

Role of High Tibial Osteotomy in Chronic Posterior Cruciate Ligament and Posterolateral Corner Knee Instability

“…Otherwise, if the osteotomy gap is too large, the correction can be performed gradually, beginning on the 7 th -10 th post-operative day, with emicallotaxis technique. The result is verified under image intensifier, a small amount of compression is performed, the rods are tightened and the skin is closed (Catagni et al, 1994;Klinger et al, 2001;Ohsawa et al, 2006;Viskontas et al, 2006).…”

“…Some Authors (Klinger et al, 2001;Ohsawa et al, 2006;Viskontas et al, 2006) suggested that an opening wedge HTO with emicallotaxis and external fixator is the treatment that should be chosen to correct the malalignment, however we prefer to use this technique with a circular external fixator (Taylor Spatial Frame, Smith & Nephew, Memphis, Tennesseee) only in deformities that need a correction greater than 12.5°. In these cases HTO is associated to a greater rate of complications, such as delayed unions, nonunions and an unstable osteotomy, due to a too large osteotomy gap.…”

Evaluation of lateral closed wedge high tibial osteotomy for medial compartment osteoarthritis

“…Different types of the implants have been used for fixation of osteotomy. Less extensive implants would probably cause least disturbance for any future replacement procedures 9,11,12 . We used single staple for fixation as it is a simple procedure and the implant is cheap.…”

Greater frequency of distraction accelerates bone formation in open-wedge proximal tibial osteotomy with hemicallotasis

“…Recently, tibial open-wedge osteotomy with hemicallotasis (HCO), a progressive distraction technique using an external fixator, has gained interest (Turi et al 1987, Fowler et al 1991, Magyar et al 1998, Klinger et al 2001, Weale et al 2001, Gerdhem et al 2002. HCO has several advantages over conventional high tibial osteotomy such as closed-wedge or dome osteotomy, including a smaller incision, easier acquisition of accurate correction, and allowance of earlier mobilization and weight bearing (Fowler et al 1991, Klinger et al 2001).…”

“…HCO has several advantages over conventional high tibial osteotomy such as closed-wedge or dome osteotomy, including a smaller incision, easier acquisition of accurate correction, and allowance of earlier mobilization and weight bearing (Fowler et al 1991, Klinger et al 2001). In addition, we have shown that HCO lead to only little shortening of the patellar tendon and less distortion of the proximal tibia postoperatively, implying an easier subsequent conversion to TKA (Nakamura et al 2001).…”