Bone Healing and Clinical Outcome Following Medial Opening‐wedge High Tibial Osteotomy Using Wedge‐Shaped Cancellous Allograft

Abstract

Objective Medial opening‐wedge high tibial osteotomy (MOWHTO) is considered to be an effective treatment for symptomatic knee osteoarthritis (KOA) of isolated the medial compartment with varus alignment of the lower extremity. However, the choice of material to fill the void remains controversial. This study aims to evaluate the bone union of the osteotomy gap using a novel wedge‐shaped cancellous allograft after MOWHTO and its effect on clinical outcomes. Methods All patients who underwent MOWHTO using a novel wedge‐shaped cancellous allograft combined with TomoFix locking compression plate (LCP) fixation between January 2016 and July 2020 were enrolled. The radiographic parameters including hip‐knee‐ankle angle (HKAA), medial proximal tibial angle (MPTA), femorotibial angle (FTA) and posterior tibial slope angle (PTSA) were measured between pre‐operative and post‐operative radiographs. Knee Society score (KSS) and range of motion (ROM) were assessed preoperatively and at last follow‐up. Patients included in this study were divided into two groups according to the correction angle: small correction group ( 0.05). All patients in this study achieved good bone healing at the final follow‐up and no significant differences in mRUST scores were seen between the SC group and LC group. The KSS‐Knee score and KSS‐Function score improved significantly from 55.4 ± 3.7 and 63.3 ± 4.6 preoperatively to 86.4 ± 2.8 (p 0.05). Conclusion For MOWHTO, the wedge‐shaped cancellous allograft was a reliable choice for providing good bone healing and clinical outcomes.

Keywords

• Bone allograft
• Bone healing
• High tibial osteotomy