Evidence map›Paper›PMID 30456568›Full record

Trial reportKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2019

Bone autografting in medial open wedge high tibial osteotomy results in improved osseous gap healing on computed tomography, but no functional advantage: a prospective, randomised, controlled trial.

Sandro F Fucentese, Philippe M Tscholl, Reto Sutter, Peter U Brucker, Dominik C Meyer, Peter P Koch

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 1 pooled it
3.8field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.

  1. Pooled it
  2. Recombinant Human BMP6 Applied Within Autologous Blood Coagulum Accelerates Bone Healing: Randomized Controlled Trial in High Tibial Osteotomy Patients.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2020
    Trial
  3. Complications of osteotomies around the knee.Bulletin of the Hospital for Joint Disease (2013) · 2026
    Review
  4. Article
  5. Article
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  10. Earlier consolidation and improved knee function of medial open wedge high tibial osteotomy with autologous bone graft.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024
    Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
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  18. Article
  19. High Tibial Osteotomy for Varus Deformity of the Knee.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2021
    Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Sandro F FucenteseDepartment of Orthopaedic Surgery, Balgrist University Hospital, University of Zurich, Forchstr. 340, 8008, Zurich, Switzerland. sandro.fucentese@balgrist.ch.
Philippe M TschollDepartment of Orthopaedic Surgery, Balgrist University Hospital, University of Zurich, Forchstr. 340, 8008, Zurich, Switzerland.
Reto SutterDepartment of Radiology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
Peter U BruckerDepartment of Orthopaedic Surgery, Balgrist University Hospital, University of Zurich, Forchstr. 340, 8008, Zurich, Switzerland.
Dominik C MeyerDepartment of Orthopaedic Surgery, Balgrist University Hospital, University of Zurich, Forchstr. 340, 8008, Zurich, Switzerland.
Peter P KochDepartment of Orthopaedic Surgery, Balgrist University Hospital, University of Zurich, Forchstr. 340, 8008, Zurich, Switzerland.
University of Zurich · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMedial open wedge high tibial osteotomy (owHTO) is a valuable surgical technique used to manage medial degeneration in varus knees. Iliac crest autograft is considered the gold standard gap-filler. It was hypothesised that iliac crest autograft promotes gap healing and improves functional outcome in owHTO.

methodsBetween 2005 and 2009, patients scheduled to undergo owHTO stabilised by a medial locking compression plate were randomised to undergo owHTO either with iliac crest autograft (group A) or without bone void filler (group B). Pre- and postoperative leg axes were recorded. At 3 and 12 months postoperatively, the healing of the osteotomy gap was measured as a percentage on CT images, and functional scores were recorded.

resultsThere were 15 patients in group A, and 25 in group B. The groups were similar in age, sex ratio, knee varus deformity, body mass index, and smoking status. Group A and B had similar preoperative varus (6.9° vs. 7.6°) and postoperative valgus (2.2° vs. 3.0°). Compared with the control group, group A had a significantly greater degree of osseous gap healing after 3 months (40.1% vs. 10.8%, p = 0.045) and 12 months (91.5% vs. 59.1%, p ≤ 0.001). Multiple linear regression analysis found that bone grafting was an independent promoting factor for gap healing, while increased preoperative varus was an independent retardant factor at 3 months (p = 0.004 and p = 0.002, respectively) and 12 months (p ≤ 0.001 and p = 0.003, respectively). Younger age was a promoting factor for gap healing on CT at 3 months (p ≤ 0.001), but not at 12 months. No correlations were found between bone healing and functional outcome, body mass index, or smoking status.

conclusionsIliac crest autograft significantly increases healing of the osteotomy gap after owHTO. Increased preoperative varus and older patient age are independent factors that delay early healing of the osteotomy. However, no functional advantage was found at 3 or 12 months postoperatively. Therefore, routine use of iliac crest autograft cannot be recommended. LEVEL OF EVIDENCE: II.

Indexed as

Bone TransplantationAdultBone PlatesFemaleHumansIliumKneeKnee JointMaleMiddle AgedOsteoarthritis, KneeOsteotomyPostoperative PeriodProspective StudiesRegression AnalysisTibiaBone graftingBone void fillerHTOIliac crestMedial open wedge osteotomyOsteotomyUnion

Identifiers

PMID30456568
OpenAlexW2901899298

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.