The degree of correction in open-wedge high tibial osteotomy compromises bone healing: A consecutive review of 101 cases.
Bone healing
Lateral hinge fracture
Open-wedge high tibial osteotomy
Osteotomy gap
Journal
The Knee
ISSN: 1873-5800
Titre abrégé: Knee
Pays: Netherlands
ID NLM: 9430798
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
30
06
2020
revised:
21
01
2021
accepted:
18
02
2021
pubmed:
21
3
2021
medline:
13
7
2021
entrez:
20
3
2021
Statut:
ppublish
Résumé
The bone healing in open-wedge high tibial osteotomy (OWHTO) proceeds gradually by a filling of the osteotomy gap. This can comprise several risk factors. A retrospective study analysed the clinical and radiological course of 101 consecutive OWHTOs in 96 patients. The following risk factors were considered: age, body mass index, tobacco consumption, amount of tobacco consumption, severity of comorbidities, infection of the surgical area, occurrence of a lateral hinge fracture and the degree of correction. The bone healing was evaluated by using the modified Radiographic Union Score for Tibial fractures (RUST). A disturbance in bone healing was observed in 16 of the 101 osteotomies. Binary logistic regression analysis showed a correlation between the angle of the opening wedge and the development of a disturbance in bone healing (P = 0.002). The odds ratio indicated an increase in the risk of a disturbance in bone healing of 56% with each additional degree of correction. For the risk factor 'age' a statistical trend was recognizable (P = 0.077) with the risk of a disturbance in bone healing in higher age. Lateral hinge fractures seem not to have a detrimental effect on the filling of the osteotomy gap. An increase in the opening wedge bears the risk of a disturbance in bone healing.
Sections du résumé
BACKGROUND
BACKGROUND
The bone healing in open-wedge high tibial osteotomy (OWHTO) proceeds gradually by a filling of the osteotomy gap. This can comprise several risk factors.
METHODS
METHODS
A retrospective study analysed the clinical and radiological course of 101 consecutive OWHTOs in 96 patients. The following risk factors were considered: age, body mass index, tobacco consumption, amount of tobacco consumption, severity of comorbidities, infection of the surgical area, occurrence of a lateral hinge fracture and the degree of correction. The bone healing was evaluated by using the modified Radiographic Union Score for Tibial fractures (RUST).
RESULTS
RESULTS
A disturbance in bone healing was observed in 16 of the 101 osteotomies. Binary logistic regression analysis showed a correlation between the angle of the opening wedge and the development of a disturbance in bone healing (P = 0.002). The odds ratio indicated an increase in the risk of a disturbance in bone healing of 56% with each additional degree of correction. For the risk factor 'age' a statistical trend was recognizable (P = 0.077) with the risk of a disturbance in bone healing in higher age.
CONCLUSION
CONCLUSIONS
Lateral hinge fractures seem not to have a detrimental effect on the filling of the osteotomy gap. An increase in the opening wedge bears the risk of a disturbance in bone healing.
Identifiants
pubmed: 33743262
pii: S0968-0160(21)00072-7
doi: 10.1016/j.knee.2021.02.025
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
478-485Informations de copyright
Copyright © 2021 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.