Comparative study of medial opening-wedge high tibial osteotomy using 2 different implants

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Sports medicine

Background:

• Opening-wedge high tibial osteotomy (HTO) is a surgical procedure to correct knee alignment.
• The choice of fixation plate can influence surgical outcomes and complication rates.
• Evaluating novel fixation devices is crucial for improving patient results.

Purpose of the Study:

• To compare the clinical and radiographic outcomes of opening-wedge HTO using a short spacer plate (Aescula) versus a rigid long plate (TomoFix).
• To assess complication rates, including plate-related issues and loss of correction, at 2-year follow-up.

Main Methods:

• Retrospective analysis of 94 opening-wedge HTOs with the Aescula plate (Group I) and 92 with the TomoFix plate (Group II).
• Clinical evaluation using Knee Society scores and radiographic assessment of mechanical tibiofemoral angle (mTFA) preoperatively and at 2-year follow-up.
• Complication rates were systematically recorded and compared between the two groups.

Main Results:

• Group II (TomoFix) had a significantly lower overall complication rate (26%) and plate-related complication rate (9%) compared to Group I (Aescula) (38% and 20%, respectively).
• While both groups showed improvement in Knee Society scores, Group II achieved significantly higher postoperative scores.
• Group II also demonstrated better maintenance of the mechanical tibiofemoral angle at follow-up.

Conclusions:

• The Aescula short spacer plate is associated with a higher incidence of plate-related complications and loss of correction after opening-wedge HTO compared to the TomoFix plate.
• The rigid TomoFix plate appears to provide more stable fixation and better long-term correction in this patient cohort.
• Further investigation into the biomechanical properties and long-term efficacy of short spacer plates in HTO is warranted.