The role of bone void fillers in medial opening wedge high tibial osteotomy: a systematic review

Slevin, Omer; Ayeni, Olufemi R.; Hinterwimmer, Stefan; Tischer, Thomas; Feucht, Matthias J.; Hirschmann, Michael T.

doi:10.1007/s00167-016-4297-5

Cited by 82 publications

(82 citation statements)

References 46 publications

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“…This is in accordance with epidemiological studies that show more people with knee OA in women than men who are done elsewhere such as in the United States and Egypt. This may be related to the hypothesis that the number of people with OA is due to hormonal factors, namely reduced estrogen levels and progestin at the age of menopause (Slevin, 2016;Sun, 2016).…”

Section: Discussionmentioning

confidence: 99%

Clinical Evaluation Of Post High Tibial Osteotomy Patients In Regional General Hospitals Dr. Soetomo Surabaya, Husada Utama Hospital Surabaya, Al-Irsyad Hospital Surabaya In 2010 - 2015

Limbong

Utomo

2019

Qanun Medika

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Osteoarthritis (OA) of the knee is a disruption in the knee joint which is characterized by pathological changes in the structure in the knee joint that occur progressively. High Tibial Osteotomy (HTO) is a therapeutic option for treating isolated medial compartment OA in varus genu and one of the routine surgical procedures performed in the orthopedic field. As the number of OA cases increases, the number of high tibial osteotomy (HTO) procedures also increases, so clinical evaluation is needed to see whether HTO can meet patient expectations. This study was a retrospective descriptive study with a sample of patients who had undergone the 2010 to 2015 open wedge high tibial osteotomy (OWHTO) procedure. The evaluation used the Knee Society Score, Knee Injury and Osteoarthritis Outcome Score, and Modified Hospital instruments for Special Surgery Knee Scoring. The data obtained are then grouped and analyzed to calculate the average of each instrument. The results showed a sample of 6 knees consisting of 2 male samples (33.3%) and 4 female samples (66.7%). All samples are over 35 years old. The evaluation results using KOOS scores obtained the mean value of the pain component was 77.7; complaint component = 70.3; daily activity component = 76.2; sports and recreation components = 47.9; and components of quality of life = 74.1. On the SSC score, the average knee score was 70.8 and the average functional score was 61.6. Whereas the HSS score obtained by the average functional score is 81.5. This study produced each score with a good average value. This shows that the choice of the High Tibial Osteotomy operating technique provides satisfactory operating results. So that the High Tibial Osteotomy surgery technique can be an option in the case of Osteoarthritis. With the many choices of types of surgery in patients with Osteoarthritis, the High Tibial Osteotomy can be a good choice for patient satisfaction. Keywords: Osteoarthritis, High Tibial Osteotomy, Knee Society Score, Knee Injury and Osteoarthritis Outcome Score, Modified Hospital for Special Surgery Knee ScoringCorrespondence to: liliosanci@gmail.com ABSTRAK Osteoartritis (OA) lutut adalah gangguan pada sendi lutut yang ditandai oleh perubahan patologis pada struktur di dalam sendi lutut yang terjadi secara progresif. High Tibial Osteotomy (HTO) merupakan pilihan terapi untuk penanganan isolated medial compartement OA pada genu varus dan salah satu prosedur operasi yang rutin dilakukan di bidang orthopedi. Dengan meningkatnya jumlah kasus OA meningkat pula jumlah prosedur high tibial osteotomy (HTO), sehingga perlu dilakukan evaluasi klinis untuk melihat apakah HTO dapat memenuhi harapan pasien. Penelitian ini merupakan penelitian deskriptif retrospektif dengan sampel pasien yang telah menjalani prosedur open wedge high tibial osteotomy (OWHTO) 2010 sampai 2015. Evaluasi menggunakan instrument Knee Society Score, Knee Injury and Ostoarthritis Outcome Score, dan Modified Hospital for Special Surgery Knee Scoring. Data yang didapat selanjutnya dikelompokkan dan dianalisa utk menghitung rata-rata dari masing-masing instrumen. Hasil penelitian didapatkan sampel sejumlah 6 lutut yang terdiri dari 2 sampel laki-laki (33,3%) dan 4 sampel perempuan (66,7%). Semua sampel berusia di atas 35 tahun. Hasil evaluasi menggunakan skor KOOS didapatkan nilai rerata komponen nyeri adalah 77,7; komponen keluhan = 70,3; komponen aktivitas harian = 76,2; komponen olahraga dan rekreasi = 47,9; dan komponen kualitas hidup = 74,1. Pada skor KSS didapatkan rerata knee score adalah 70,8 dan rerata functional score adala 61,6. Sedangkan pada skor HSS didapatkan rerata functional score adalah 81.5. Penelitian ini menghasilkan masing-masing skor dengan nilai rata-rata yang bagus. Hal ini menunjukkan bahwa pilihan teknik operasi High Tibial Osteotomy memberikan hasil operasi yang memuaskan. Sehingga teknik operasi High Tibial Osteotomy dapat menjadi salah satu pilihan pada kasus Osteoarthritis. Dengan banyaknya pilihan macam operasi pada penderita Osteoarthritis maka High Tibial Osteotomy dapat menjadi satu pilihan yang baik untuk kepuasan pasien. Kata kunci: Osteoartritis, High Tibial Osteotomy, Knee Society Score, Knee Injury and Ostoarthritis Outcome Score, Modified Hospital for Special Surgery Knee ScoringKorespondensi: liliosanci@gmail.com

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Section: Discussionmentioning

confidence: 99%

Clinical Evaluation Of Post High Tibial Osteotomy Patients In Regional General Hospitals Dr. Soetomo Surabaya, Husada Utama Hospital Surabaya, Al-Irsyad Hospital Surabaya In 2010 - 2015

Limbong

Utomo

2019

Qanun Medika

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“…In fact, the authors concluded that synthetic bone substitutes cannot be recommended. 11 In a prospective study by Ferner et al, 12 significantly higher rates of nonunion were observed after augmentation without synthetic bone grafting. Problem solved, and the evidence seemed clear: there is no need for bone grafting in open-wedge HTOs.…”

Section: See Related Article On Page 2621mentioning

confidence: 94%

“…The work by Nha et al 16 seems to support previous studies. [9][10][11] Nonetheless, based on the current published evidence, we can possibly conclude that bone grafting, whether with autologous or synthetic bone graft, is not needed for open-wedge HTOs with gaps <10 to 12 mm. Finally, this topic offers itself for a high-quality randomized prospective multicenter study.…”

Section: See Related Article On Page 2621mentioning

confidence: 97%

Editorial Commentary: Go Autologous or Go Home: Open-Wedge High Tibial Osteotomies Do Not Benefit From Synthetic Bone Grafting

Hohmann¹

2018

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Open-wedge high tibial osteotomies result in a gap on the medial aspect of the proximal tibia and filling the gap with autologous bone graft may reduce nonunion rates and result in better functional outcomes. Autologous bone grafts are the golden standard, but synthetic bone fillers are an attractive option; however, current evidence suggests that synthetic bone grafts do not result in higher union rates and may be detrimental during open-wedge osteotomies.

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“…Two recent systematic analyses compared historically reported groups of patients with autograft, allograft, synthetic material, and no bone graft, demonstrating comparable rates of nonunion or delayed union. 27,28 One recommendation was that in corrections <10 mm and with the use of locking-plate technology, bone graft may not be necessary. 28 However, the primary limitation with locking plates tends to be implant-related discomfort, which has been reported in a large proportion of patients, approaching approximately 40% in some series.…”

Section: Implant Optionsmentioning

confidence: 99%

“…27,28 One recommendation was that in corrections <10 mm and with the use of locking-plate technology, bone graft may not be necessary. 28 However, the primary limitation with locking plates tends to be implant-related discomfort, which has been reported in a large proportion of patients, approaching approximately 40% in some series. 26 In recent years, alternative fixation devices have been designed using polyetheretherketone (PEEK).…”

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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The role of bone void fillers in medial opening wedge high tibial osteotomy: a systematic review

Abstract: III.

Cited by 82 publications

References 46 publications

Clinical Evaluation Of Post High Tibial Osteotomy Patients In Regional General Hospitals Dr. Soetomo Surabaya, Husada Utama Hospital Surabaya, Al-Irsyad Hospital Surabaya In 2010 - 2015

Clinical Evaluation Of Post High Tibial Osteotomy Patients In Regional General Hospitals Dr. Soetomo Surabaya, Husada Utama Hospital Surabaya, Al-Irsyad Hospital Surabaya In 2010 - 2015

Editorial Commentary: Go Autologous or Go Home: Open-Wedge High Tibial Osteotomies Do Not Benefit From Synthetic Bone Grafting

Implant Alternatives for Tibial Osteotomies

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