Total knee arthroplasty after high tibial osteotomy: a comparison of opening and closing wedge osteotomy

Bastos, Ricardo; Magnussen, Robert A.; Duthon, Victoria Lysiane Agnes; Demey, Guillaume; Servien, Elvire; Granjeiro, José Mauro; Neyret, Philippe

doi:10.1007/s00264-012-1765-5

Cited by 42 publications

(59 citation statements)

References 26 publications

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“…Three outcomes of RCTs were different from all studies, which may be related to the sample size or other factors. Second, the follow-up period was diverse, most studies were < 2 years, two studies 14,30 were > 5 years, and partial results were different from previous studies. Bastos Filho et al 30 found that the patellar height (BPI) of OWO was not statistically different from that of CWO.…”

Section: Discussionmentioning

confidence: 95%

“…Second, the follow-up period was diverse, most studies were < 2 years, two studies 14,30 were > 5 years, and partial results were different from previous studies. Bastos Filho et al 30 found that the patellar height (BPI) of OWO was not statistically different from that of CWO. van Egmond et al 14 found that the clinical results of CWO were better than those of OWO, according to the VAS satisfaction.…”

Section: Discussionmentioning

confidence: 95%

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Comparison between Closing-Wedge and Opening-Wedge High Tibial Osteotomy in Patients with Medial Knee Osteoarthritis: A Systematic Review and Meta-analysis

Sun

Zhou

et al. 2016

J Knee Surg

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Young active patients with medial knee osteoarthritis (OA) combined with varus leg alignment can be treated with high tibial osteotomy (HTO) to stop the progression of OA and avoid or postpone total knee arthroplasty (TKA). Closing-wedge osteotomy (CWO) and opening-wedge osteotomy (OWO) are the most commonly used osteotomy techniques. The purpose of this study was to compare the clinical and radiologic outcomes and complications between OWO and CWO. We retrospectively evaluated 23 studies including 17 clinical trials from published databases from their inception to May 2015. We evaluated the clinical outcomes including operation time, visual analog scale (VAS), maximal flexion, and hospital for special surgery knee (HSS) score. The radiologic outcomes included patellar height measured by posterior tibial slope angle, hip-knee-ankle (HKA) angle, femorotibial (FT) axis, and limb length. Complications recorded included the incidence of deep vein thrombosis (DVT), common peroneal nerve injury, opposite cortical fracture, etc. There were no differences in most of the clinical outcomes except the operation time. OWO increased the posterior slope angle and limb length, decreased the patellar height, and provided higher accuracy of correction. CWO led to a higher incidence of opposite cortical fracture.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 95%

Comparison between Closing-Wedge and Opening-Wedge High Tibial Osteotomy in Patients with Medial Knee Osteoarthritis: A Systematic Review and Meta-analysis

Sun

Zhou

et al. 2016

J Knee Surg

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“…Some studies [8,11,19] reported that the femorotibial angle after TKA following HTO did not significantly differ from that after primary TKA. Furthermore, some studies found that the patellar height was altered after HTO [6,28]. Bae et al [10] and Efe et al [13] reported that the IS ratio did not significantly differ between the RHTO and PTKA groups; however, Kazakos et al [18] reported the opposite.…”

Section: Discussionmentioning

confidence: 99%

“…Conversion TKA after HTO may be more technically demanding than primary TKA due to the difficulty of the surgical approach, the ligamentous imbalance, and the anatomical distortion of the proximal tibial metaphysis [17,37]. Bastos et al [28] reported that incidence of additional procedures were required for the surgical approach because of the difficult patellar eversion in conversion TKA after HTO. Nagamine et al [38] reported that a tibial offset stem may be required to solve the problem of translational and meta-diaphyseal mismatch of the tibia.…”

Section: Discussionmentioning

confidence: 99%

A meta-analysis of total knee arthroplasty following high tibial osteotomy versus primary total knee arthroplasty

Sun

Wang

2020

Arch Orthop Trauma Surg

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Background This study was performed to compare the clinical and radiographic outcomes of total knee arthroplasty (TKA) following high tibial osteotomy (HTO) versus primary TKA. Methods Relevant trials were identified via a search of Ovid, PubMed and the Cochrane Central Register of Controlled Trials from inception to 10 January 2019. A meta-analysis was performed to compare postoperative outcomes between revising HTO to TKA (RHTO) and primary TKA (PTKA) with respect to Knee Society Score (KSS), 10-year survival rate, operative time, flexion and extension angle, infection rate and radiographic results. Results Sixteen of 340 studies involving 103,552 adult patients (RHTO group, n = 3955; PTKA group, n = 99,597) were eligible for inclusion in the meta-analysis. Compared with primary TKA, revising HTO to TKA required longer operative time and had a higher infection rate (P < 0.05). The PTKA group had better flexion angle than the RHTO group (P < 0.05). There were no significant differences between the two groups in the KSS, extension angle, radiographic results and 10-year survival rate (P > 0.05). Conclusion Patients who undergo conversion of HTO to TKA have similar 10-year survival rate, KSS, extension angle and radiographic results as patients who undergo primary TKA. However, conversion of HTO to TKA required longer operative time and had a higher infection rate than performing primary TKA. Moreover, conversion of HTO to TKA is associated with poorer flexion angle than primary TKA.

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“…Moreover, in this study, stemmed implants were used in 17% of the revised UKAs and in just 4% of the revised Htos. Bastos Filho et al (47) found an increased need for tibial tubercle osteotomy in tKA after CWHto and for medial release in patients previously submitted to oWHto.…”

Section: Conversion To Total Knee Arthroplasty (Tka)mentioning

confidence: 98%

High tibial osteotomy in varus knees: indications and limits

Loia¹,

Vanni²,

Rosso³

et al. 2016

Joints

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Abstractopening wedge high tibial osteotomy (oWHto) is a surgical procedure that aims to correct the weight-bearing axis of the knee, moving the loads laterally from the medial compartment. Conventional indications for oWHto are medial compartment osteoarthritis and varus malalignment of the knee; recently oWHto has been used successfully in the treatment of double and triple varus. oWHto, in contrast to closing wedge high tibial osteotomy, does not require fibular osteotomy or peroneal nerve dissection, or lead to disruption of the proximal tibiofibular joint and bone stock loss. For these reasons, interest in this procedure has grown in recent years. the aim of this study is to review the literature on oWHto, considering indications and prognostic factors (body mass index, grade of osteoarthritis, instability, range of movement and age), outcomes at midterm follow-up, and limits of the procedure (slope modifications, patellar height changes and difficulties in conversion to a total knee arthroplasty).Keywords: high tibial osteotomy, knee, osteoarthritis, opening wedge, prognostic factors. IntroductionHigh tibial osteotomy (Hto) is a widely accepted procedure for treating varus alignment of the knee associated with medial compartment overload/osteoarthritis (oA). the purpose of the procedure, which may be a medial opening wedge, lateral closing wedge, dome or "en chevron" osteotomy, is to shift the mechanical axis of the lower limb from the medial to the lateral compartment, thereby reducing the load and contact area over the medial compartment. the first references to Hto date back to 1961 (1); for a long time, closing wedge high tibial osteotomy (CWHto) was the gold standard of treatment in this field. Consequently, there exist numerous studies dealing with aspects (survival and complications) of CWHto. CWHto involves fibular osteotomy, common peroneal nerve dissection, proximal tibiofibular joint disruption, and bone stock loss (2, 3). Furthermore, with this procedure it is difficult to obtain gradual correction of the axis. For these reasons, opening wedge high tibial osteotomy (oWHto) has been gaining popularity in recent years. Moreover, oWHto allows for better tuning of the osteotomy as well as triplanar and gradual correction. the literature of recent years therefore contains various papers on different aspects of oWHto: indications, surgical technique, limits and results. the aim of this study is to review the literature on oWHto, considering indications and prognostic factors, outcomes and limits of the procedure. IndicationsCorrect patient selection is mandatory for achieving good results with oWHto (4, 5). According to the literature, the factors that could influence the prognosis are: age, body mass index (BMi), grade of oA, range of motion (RoM), and associated instability. in order to gain a better understanding of the correct indications for oWHto, we have reviewed each of these factors as examined in the most recent literature.

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Total knee arthroplasty after high tibial osteotomy: a comparison of opening and closing wedge osteotomy

Cited by 42 publications

References 26 publications

Comparison between Closing-Wedge and Opening-Wedge High Tibial Osteotomy in Patients with Medial Knee Osteoarthritis: A Systematic Review and Meta-analysis

Comparison between Closing-Wedge and Opening-Wedge High Tibial Osteotomy in Patients with Medial Knee Osteoarthritis: A Systematic Review and Meta-analysis

A meta-analysis of total knee arthroplasty following high tibial osteotomy versus primary total knee arthroplasty

High tibial osteotomy in varus knees: indications and limits

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