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- Title
Uniplane medial opening wedge high tibial osteotomy relative to a biplane osteotomy can reduce the incidence of lateral-hinge fracture.
- Authors
Nha, Kyung Wook; Shin, Myung Jin; Suh, Dong Won; Nam, Young Jun; Kim, Ki Seong; Kyung, Bong Soo
- Abstract
<bold>Purpose: </bold>With surgical modifications reflecting plate design differences of the specific rigid locking plate adding a metal wedge, uniplane high tibial osteotomy (HTO) has fewer lateral-hinge fractures and fewer plate irritations than biplane HTO.<bold>Methods: </bold>Uniplane HTO with a rigid locking plate adding a metal wedge was compared with biplane HTO with a rigid locking plate including a proximal D-hole. For comparison, the HTO patients' medical records and radiological results in a single institution were retrospectively reviewed. The Oxford knee score 2 years post-operation, CT scan at post-operative day 2 and serial standing long-bone scanography were reviewed to evaluate clinical outcome and radiological results, including the incidence of lateral-hinge fracture, plate irritation and correction loss to varus alignment.<bold>Results: </bold>A total of 103 knees, including 59 uniplane HTO and 44 biplane HTO, were enrolled. The Oxford scores were 38.1 ± 7.8 in the uniplane group and 35.9 ± 8.3 in the biplane group (ns). On CT scans, more lateral-hinge fractures developed in the biplane group, and seven knees (12%) of the uniplane group and 12 knees (27%) of the biplane group had Takeuchi type I stable hinge fracture (p < 0.05); unstable fracture was not noted in either group. Plate irritation occurred in nine knees (19%) of the uniplane group and in 14 knees (32%) of the biplane group, and the difference was statistically significant (p < 0.05).<bold>Conclusion: </bold>In clinical situations including the use of surgical modifications reflecting plate design differences, fewer lateral-hinge fractures developed after uniplane medial opening-wedge HTO compared with biplane HTO. Uniplane HTO potentially represents a better option than biplane HTO for the prevention of lateral-hinge fracture.<bold>Level Of Evidence: </bold>IV.
- Subjects
OSTEOTOMY; TREATMENT of fractures; KNEE injuries; PATIENTS; BONE fracture prevention; KNEE surgery; TIBIA surgery; TIBIA injuries; KNEE diseases; BONE diseases; RESEARCH; ORTHOPEDIC implants; RESEARCH methodology; RETROSPECTIVE studies; DISEASE incidence; EVALUATION research; MEDICAL cooperation; COMPARATIVE studies; OSTEOARTHRITIS; TIBIAL fractures; REHABILITATION
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2020, Vol 28, Issue 5, p1436
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-019-05522-2