[Bone void fillers in osteotomies : If, when, and which type?]

Area of Science:

• Orthopedic Surgery
• Biomaterials Science

Background:

• Medial opening wedge high tibial osteotomy (HTO) is a common surgical procedure for medial knee osteoarthritis.
• The procedure involves creating an open wedge in the proximal tibia, resulting in a bone void.
• The management of this bone void, whether by filling or leaving it empty, is a subject of ongoing discussion.

Purpose of the Study:

• To provide a comprehensive overview of bone void fillers used in HTO.
• To analyze the advantages and disadvantages of different bone void filler materials.
• To evaluate the influence of bone void fillers on clinical and radiographic outcomes after HTO.

Main Methods:

• Literature review of studies on bone void fillers in HTO.
• Categorization of fillers into autologous, allogenic, and synthetic materials.
• Analysis of reported clinical and radiographic outcomes associated with different filler types.

Main Results:

• Various bone void fillers are available, including autografts, allografts, and synthetic options.
• Each filler type presents unique benefits and drawbacks regarding handling, integration, and cost.
• The necessity and impact of bone void fillers on patient outcomes require further investigation.

Conclusions:

• Bone void fillers are utilized in HTO to manage the defect created during the procedure.
• The choice of filler material can influence the surgical outcome, but evidence is still limited.
• Further research is needed to establish definitive guidelines on the use and necessity of bone void fillers in HTO.