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Clinical Outcomes and Complications During and After Medial Open-Wedge High Tibial Osteotomy Using a Locking Plate : A 3-to 7-Year Follow-up Study

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Title: Clinical Outcomes and Complications During and After Medial Open-Wedge High Tibial Osteotomy Using a Locking Plate : A 3-to 7-Year Follow-up Study
Authors: Yabuuchi, Koji Browse this author
Kondo, Eiji Browse this author →KAKEN DB
Onodera, Jun Browse this author →KAKEN DB
Onodera, Tomohiro Browse this author →KAKEN DB
Yagi, Tomonori Browse this author
Iwasaki, Norimasa Browse this author →KAKEN DB
Yasuda, Kazunori Browse this author →KAKEN DB
Keywords: complications
high tibial osteotomy
knee osteoarthritis
medial open-wedge
Issue Date: Jun-2020
Publisher: SAGE Publications
Journal Title: Orthopaedic journal of sports medicine
Volume: 8
Issue: 6
Start Page: 2325967120922535
Publisher DOI: 10.1177/2325967120922535
Abstract: Background: Outcomes and complications at mid- or long-term follow-up after medial open-wedge high tibial osteotomy (MOWHTO) with the TomoFix locking plate have not been fully evaluated. Purpose: To evaluate the complications and midterm clinical outcomes after MOWHTO using a TomoFix. Study Design: Case series; Level of evidence, 4. Methods: Enrolled in this study were 80 patients (85 knees) who underwent MOWHTO with the TomoFix locking plate between 2009 and 2013. There were 66 women and 14 men, with a mean age of 61.5 years at the time of surgery. The diagnosis was medial osteoarthritis in 76 knees and spontaneous osteonecrosis of the knee in 9 knees. Metal removal and second-look arthroscopy were performed in all cases. Clinical and radiological examinations were performed at final follow-up after surgery (mean, 4.5 years). Results: The mean Japanese Orthopaedic Association score and Knee injury and Osteoarthritis Outcome Score improved significantly from pre- to postoperatively (P< .0001). The weightbearing line percentage shifted to pass through a point 67.7% lateral from the medial edge of the tibial plateau. The Caton-Deschamps index changed significantly from 0.88 to 0.66 at final follow-up (P< .0001). The mean posterior tibial slope changed significantly from 8.9 degrees to 11.9 degrees at final follow-up (P< .0001). Limb length was significantly increased after MOWHTO (10.3 mm;P< .0001). During plate removal, 14 locking screws were found to be broken in 9 knees (10.6%). The articular cartilage grade of the patellofemoral joint was significantly higher in the second arthroscopy than in the first arthroscopy (P< .0001). The cumulative rate of all complications was 41.2%, with major complications (ie, those requiring additional or extended treatment) in 24.7%. Conclusion: Postoperative outcome scores indicated significant improvement after MOWHTO, although the cumulative rate of all complications was 41.2% and the rate of major complications was 24.7%. These results indicate that MOWHTO with the TomoFix is a technically demanding procedure. Careful preoperative planning and meticulous surgical technique are needed to decrease the incidence of complications associated with MOWHTO.
Type: article
Appears in Collections:国際連携研究教育局 : GI-CoRE (Global Institution for Collaborative Research and Education : GI-CoRE) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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