Extra-articular Lateral Hinge Fracture Does Not Affect the Outcomes in Medial Open-Wedge High Tibial Osteotomy Using a Locked Plate System.
Study Goal
The researchers aimed to compare radiologic and clinical outcomes in patients with and without lateral hinge fractures during medial open-wedge high tibial osteotomy (MOWHTO) and assess whether such fractures affected midterm outcomes.
Results Summary
The study found no significant differences in radiologic changes or functional deterioration between patients with and without lateral hinge fractures during midterm follow-up, with no correction loss or union problems observed. Improvements in clinical scores and knee range of motion were also similar across groups.
Population
Patients with knee osteoarthritis undergoing MOWHTO (average age 56.0 years, range 42-67).
Effective Dosage
Full weight-bearing walking commenced at 6 weeks postoperatively.
Duration
Average follow-up period was 62.2 months (range 24-120 months).
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
medial open-wedge high tibial osteotomy (MOWHTO) using a locked plate system | no change | postoperative hip-knee-ankle angle | patients with lateral hinge fractures (types I and II) and nonfracture groups | no significant changes | showed no significant changes in serial evaluations | #1 |
medial open-wedge high tibial osteotomy (MOWHTO) using a locked plate system | no change | femorotibial angle | patients with lateral hinge fractures (types I and II) and nonfracture groups | no significant changes | showed no significant changes in serial evaluations | #2 |
medial open-wedge high tibial osteotomy (MOWHTO) using a locked plate system | no change | medial proximal tibial angle | patients with lateral hinge fractures (types I and II) and nonfracture groups | no significant changes | showed no significant changes in serial evaluations | #3 |
medial open-wedge high tibial osteotomy (MOWHTO) using a locked plate system | no change | posterior tibial slope angle | patients with lateral hinge fractures (types I and II) and nonfracture groups | no significant changes | showed no significant changes in serial evaluations | #4 |
medial open-wedge high tibial osteotomy (MOWHTO) using a locked plate system | no change | American Knee Society Score | patients with lateral hinge fractures (types I and II) and nonfracture groups | not significantly different | improvements were not significantly different among the groups | #5 |
medial open-wedge high tibial osteotomy (MOWHTO) using a locked plate system | no change | knee range of motion | patients with lateral hinge fractures (types I and II) and nonfracture groups | not significantly different | improvements were not significantly different among the groups | #6 |
medial open-wedge high tibial osteotomy (MOWHTO) using a medial locked plate system and relatively conservative rehabilitation protocol with full weight-bearing walking commenced at 6 weeks postoperatively | no change | midterm outcomes | patients with type I and II lateral hinge fractures | no radiologic changes or functional deterioration | showed no radiologic changes or functional deterioration | #7 |
PURPOSE: To compare the radiologic and clinical outcomes in patients with and without lateral hinge fractures (LHFs) during medial open-wedge high tibial osteotomy (MOWHTO) using a locked plate system, as well as to assess whether LHFs could affect the midterm outcomes. METHODS: From May 2008 to November 2015, 164 knees underwent MOWHTO using a locked plate system for the treatment of knee osteoarthritis. LHFs were recognized by radiographs during or after the high tibial osteotomy and were not additionally treated. In all patients, we applied the same rehabilitation protocol that allowed full weight bearing at 6 weeks. Patients were divided into LHF (types I and II) and nonfracture groups. Radiologically, we compared any serial changes in the hip-knee-ankle angle, femorotibial angle, medial proximal tibial angle, and posterior tibial slope angle from the immediate postoperative radiographs to the final radiographs. The union process of the osteotomy site among the groups was also evaluated. Clinically, the postoperative American Knee Society Score and knee range of motion at latest follow-up were compared. Postoperative complications were also evaluated. RESULTS: The average age at operation was 56.0 years (range, 42-67 years), and the average follow-up period was 62.2 months (range, 24-120 months). LHFs were observed in 37 knees (22.6%) and were divided into the type I (16 knees) and type II (21 knees) groups. All groups showed no significant changes in serial evaluations of the postoperative hip-knee-ankle angle, femorotibial angle, medial proximal tibial angle, and posterior tibial slope angle. The improvements in the American Knee Society Score and knee range of motion were not significantly different among the groups. No patients showed correction loss or union problems. CONCLUSIONS: Type I and II LHFs in MOWHTO using a medial locked plate system and relatively conservative rehabilitation protocol with full weight-bearing walking commenced at 6 weeks postoperatively showed no radiologic changes or functional deterioration during midterm follow-up. LEVEL OF EVIDENCE: Level IV, case series.