Evolution of open-wedge high-tibial osteotomy: experience with a special angular stable device for internal fixation...

Area of Science:

• Orthopedic surgery
• Biomechanics
• Regenerative medicine

Background:

• Overload osteoarthritis necessitates early intervention, even without significant knee varus deformity.
• Realignment of the extremity is crucial to reduce medial compartment overload and retard joint surface damage.
• Open-wedge high-tibial osteotomy (OWHTO) is a key surgical technique for managing knee osteoarthritis.

Purpose of the Study:

• To evaluate the efficacy of open-wedge high-tibial osteotomy (OWHTO) using the TomoFix plate.
• To assess the healing progression and outcomes of OWHTO without interposition materials.
• To determine if OWHTO can successfully treat unicompartmental gonarthrosis.

Main Methods:

• Retrospective study of 53 consecutive cases undergoing OWHTO.
• Utilized the TomoFix plate for angular-stable fixation.
• Gap openings ranged from 5 mm to 20 mm; no interposition material was used.
• Standard radiographs were used to monitor ossification.

Main Results:

• Ossification of the osteotomy gap consistently progressed from the lateral to the medial side.
• Approximately 75% of the gap was filled with new bone within 6-18 months post-surgery.
• Successful treatment of unicompartmental gonarthrosis was observed.

Conclusions:

• Open-wedge high-tibial osteotomy (OWHTO) with TomoFix plate fixation is effective for unicompartmental gonarthrosis.
• The procedure promotes natural bone regeneration without the need for bone grafts or substitutes.
• Early surgical correction is recommended for bowed legs to prevent osteoarthritis progression.