Related Experiment Videos
Open wedge tibial osteotomy with acrylic bone cement as bone substitute
1Hopital Henri Mondor, 51 Avenue du Mal Lattrede, Tassigny, 94010 Creteil, France. philippe.hernigou@wanadoo.fr
The Knee
|May 5, 2001
Summary
This study on high tibial osteotomy (HTO) found that using acrylic cement for bone grafting in the opening wedge technique provides accurate knee alignment. HTO with cement shows good long-term survival rates, with successful conversion to total knee replacement when needed.
Area of Science:
- Orthopedic Surgery
- Biomechanics
- Biomaterials
Background:
- High tibial osteotomy (HTO) is a surgical procedure to correct knee alignment.
- Traditional opening wedge HTO often uses iliac bone grafts or external fixators.
- Alternative bone substitutes and fixation methods are explored to improve outcomes.
Purpose of the Study:
- To evaluate the efficacy and accuracy of opening wedge HTO using acrylic cement as a bone substitute.
- To assess the long-term survivorship and complication rates of this technique.
- To determine the feasibility of subsequent total knee arthroplasty after HTO with cement.
Main Methods:
- A retrospective study of 245 patients undergoing opening wedge HTO with acrylic cement and rigid internal fixation.
- Early passive and active knee motion was initiated post-operatively.
- Hip-knee-ankle (HKA) angle was measured for correction accuracy.
- Survivorship analysis was performed with conversion to total knee arthroplasty as the endpoint.
Main Results:
- Opening wedge HTO with acrylic cement achieved accurate correction, with 93% of knees within the desired 180-187 degree HKA range.
- Survivorship rates were 94% at 5 years, 85% at 10 years, and 68% at 15 years.
- Conversion to total knee arthroplasty was performed without difficulty in cases requiring it.
Conclusions:
- Opening wedge HTO utilizing acrylic cement as a bone substitute, combined with rigid internal fixation and early motion, is an accurate and effective procedure.
- This technique demonstrates favorable long-term survival rates.
- The procedure facilitates uncomplicated conversion to total knee arthroplasty when necessary.