Prospective evaluation of a new plate fixator for valgus-producing medial open-wedge high tibial osteotomy

Cotic, Matthias; Vogt, Stephan; Feucht, Matthias J.; Saier, Tim; Minzlaff, Philipp; Hinterwimmer, Stefan; Imhoff, Andreas B.

doi:10.1007/s00167-014-3287-8

Cited by 25 publications

(28 citation statements)

References 72 publications

(166 reference statements)

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“…Definition of pre-op: pretraumatic94 (range 86–99)100% (6/6). Time to RTS unknownUnknownNSStudy: Cotic et al [45], 2015, GermanyDesign: pro cohort study; FU: 2 yearsPopulation: Pts with medial compartment OA and varus malalignment or medial compartment overload combined with localized chondral defects requiring cartilage repair ( n = 28); age 45 (±11); sex 19 M (70%), 9 F (30%); BMI 25 ± 3; Co NS(Biplanar) MOW HTOFixation: second-generation peek-carbon composite plateConcomitant procedures: medial meniscectomy 5, microfracturing 1, OATS 6, ACL reconstruction 1Active and passive FROM as tolerated directly or after 6 weeks (in microfracture and OATS pts). 20-kg partial weight bearing until 6 weeks, then full weight bearing was allowedLysholm ( n = 27)51 (40–62)83 (73–94) ( p < 0.001)>100%UnknownMentioned, not adjusted for: fixation type; timing of implant removalTegner ( n = 27)5 (3–6)4 (3–5) (n.s.…”

Section: Methodsmentioning

confidence: 99%

High Rates of Return to Sports Activities and Work After Osteotomies Around the Knee: A Systematic Review and Meta-Analysis

et al. 2017

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BackgroundKnee osteotomies are proven treatment options, especially in younger patients with unicompartmental knee osteoarthritis, for certain cases of chronic knee instability, or as concomitant treatment for meniscal repair or transplantation surgery. Presumably, these patients wish to stay active. Data on whether these patients return to sport (RTS) activities and return to work (RTW) are scarce.ObjectivesOur aim was to systematically review (1) the extent to which patients can RTS and RTW after knee osteotomy and (2) the time to RTS and RTW.MethodsWe systematically searched the MEDLINE and Embase databases. Two authors screened and extracted data, including patient demographics, surgical technique, pre- and postoperative sports and work activities, and confounding factors. Two authors assessed methodological quality. Data on pre- and postoperative participation in sports and work were pooled.ResultsWe included 26 studies, involving 1321 patients (69% male). Mean age varied between 27 and 62 years, and mean follow-up was 4.8 years. The overall risk of bias was low in seven studies, moderate in ten studies, and high in nine studies. RTS was reported in 18 studies and mean RTS was 85%. Reported RTS in studies with a low risk of bias was 82%. No studies reported time to RTS. RTW was reported in 14 studies; mean RTW was 85%. Reported RTW in studies with a low risk of bias was 80%. Time to RTW varied from 10 to 22 weeks. Lastly, only 15 studies adjusted for confounders.ConclusionEight out of ten patients returned to sport and work after knee osteotomy. No data were available on time to RTS. A trend toward performing lower-impact sports was observed. Time to RTW varied from 10 to 22 weeks, and almost all patients returned to the same or a higher workload.Electronic supplementary materialThe online version of this article (doi:10.1007/s40279-017-0726-y) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

High Rates of Return to Sports Activities and Work After Osteotomies Around the Knee: A Systematic Review and Meta-Analysis

et al. 2017

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“…9 8 Bruch der Gegenkortikalis (im Bild die iBalance-Probe), welche bei allen Proben auftrat. (Aus: [11]) Abb.…”

Section: Der Orthopädeunclassified

“…Generation sind bis zu einem Korrekturwinkel von 12 mm Keilbasishöhe vergleichbar mit den Ergebnissen der TomoFix™-Platte [9]. Die biomechanischen Unterschiede zwischen diesen beiden Platten waren in der vorliegenden Studie dementsprechend gering (.…”

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Biomechanik neuer Implantate für die HTO

Pape¹,

Kaze

Hoffmann³

et al. 2017

Orthopäde

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Biomechanical characteristics of 5 tibial osteotomy plates for the treatment of medial knee joint osteoarthritis were examined. Fourth-generation tibial bone composites underwent a medial open-wedge high tibial osteotomy, using TomoFix™ standard, PEEKPower®, ContourLock®, TomoFix™ small stature plates, and iBalance® implants. Static compression load to failure and load-controlled cyclic fatigue failure tests were performed. All plates had sufficient stability up to 2400 N in the static compression load to failure tests. Screw breakage in the iBalance® group and opposite cortex fractures in all constructs occurred at lower loading conditions. The highest fatigue strength in terms of maximal load and number of cycles performed prior to failure was observed for the ContourLock® group followed by the iBalance® implants, the TomoFix™ standard and small stature plates. PEEKPower® had the lowest fatigue strength. All plates showed sufficient stability under static loading. Compared to the TomoFix™ and the PEEKPower® plates, the ContourLock® plate and iBalance® implant showed a higher mechanical fatigue strength during cyclic fatigue testing, suggesting that both mechanical static and fatigue strength increase with a wider proximal T‑shaped plate design together with diverging proximal screws. Mechanical strength of the bone-implant constructs decreases with a narrow T‑shaped proximal end design and converging proximal screws (TomoFix™) or a short vertical plate design (PEEKPower®). Published results indicate high fusion rates and good clinical results with the TomoFix™ plate, which is contrary to our findings. A certain amount of interfragmentary motion rather than high mechanical strength and stiffness seem to be important for bone healing which is outside the scope of this paper.

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“…29 Early clinical data on the second generation of this implant suggest that outcomes are positive, supporting the use of this implant in MOW HTO. 30 The PEEK wedge implant (iBalance) is designed to sit within the osteotomy site, potentially avoiding the overlying soft tissue irritation that leads to high rates of subsequent hardware removal with locking plates. 6 In addition to its lowprofile design, it has also been developed with an instrumentation system that is designed to make the procedure more reproducible and reduce the risks of steps that are conventionally associated with complications.…”

Section: Implant Optionsmentioning

confidence: 99%

Implant Alternatives for Tibial Osteotomies

Degen

Getgood

2017

J Knee Surg

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Tibial osteotomies have commonly been used to treat varus malalignment with associated medial compartment degeneration. Initially, lateral closing wedge osteotomies were commonly used. However, with the advent of improved plate osteosynthesis techniques, medial opening wedge osteotomies have become the mainstay of treatment. Presently, there are several available fixation devices, with no clear consensus on which represents the superior option. This article will serve to review the technological evolution of tibial osteotomy fixation devices, highlighting the comparative biomechanical evidence of available constructs.

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Prospective evaluation of a new plate fixator for valgus-producing medial open-wedge high tibial osteotomy

Abstract: III.

Cited by 25 publications

References 72 publications

High Rates of Return to Sports Activities and Work After Osteotomies Around the Knee: A Systematic Review and Meta-Analysis

High Rates of Return to Sports Activities and Work After Osteotomies Around the Knee: A Systematic Review and Meta-Analysis

Biomechanik neuer Implantate für die HTO

Implant Alternatives for Tibial Osteotomies

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