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Comparison between two angular stable locking plates for medial opening-wedge high tibial osteotomy: Decisive wedge
Young-Soo Shin1, Keong-Ho Kim1, Hyun-Bo Sim1
1Department of Orthopedic Surgery, Veterans Health Service Medical Center, Seoul, Republic of Korea.
Summary
This study compared two locking plates for high tibial osteotomy, finding TomoFix™ superior due to a lower non-union rate. Both implants are effective for knee osteoarthritis, but TomoFix™ is preferred for demanding patients.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Medial opening-wedge high tibial osteotomy (MOWHTO) requires stable fixation for bone healing.
- Comparing angular stable locking plates is crucial for optimizing MOWHTO outcomes.
Purpose of the Study:
- To compare radiographic and clinical outcomes of two locking plates (DWL® and TomoFix™) after MOWHTO.
- To evaluate plate-specific complications and identify the preferred implant for MOWHTO.
Main Methods:
- Prospective study of 97 patients undergoing MOWHTO for medial compartment osteoarthritis.
- Patients were divided into two groups: DWL® (n=50) and TomoFix™ (n=47).
- Clinical (HSS, WOMAC) and radiographic (mFTA, MPTA, JLCA, PTS) evaluations were performed preoperatively and at 3-year follow-up.
Main Results:
- A statistically significant difference in medial proximal tibial angle (MPTA) was observed at 3 years (P=0.033).
- Group I (DWL®) showed a higher non-union rate (4%) compared to Group II (TomoFix™, 0%).
- MPTA outcomes were associated with osteotomy technique and preoperative JLCA in Group I, and gender and BMI in Group II.
Conclusions:
- Both DWL® and TomoFix™ plates are effective for MOWHTO in treating knee osteoarthritis with varus deformity.
- TomoFix™ appears to be a better alternative due to a lower complication rate (non-union).
- The choice of implant should consider patient-specific factors and the potential for complications in highly demanding patients.
