ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2019
High tibial osteotomy with modern PEEK implants is safe and leads to lower hardware removal rates when compared to conventional metal fixation: a multi-center comparison study.
Article 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 11 papers, 1 of them a synthesis that pooled it.
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11 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Opening- and closing-wedge high tibial osteotomy are comparable and early full weight bearing is safe with angular stable plate fixation: a meta-analysis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Pooled it
- The Role of Alignment in Treating Meniscus Pathology.Current reviews in musculoskeletal medicine · 2025Review
- Effect of hardware removal and second-look arthroscopy after open-wedge high tibial osteotomy.Archives of orthopaedic and trauma surgery · 2024Article
- A systematic approach to managing complications after proximal tibial osteotomies of the knee.Journal of experimental orthopaedics · 2023Review
- Enhancing PEEK surface bioactivity: Investigating the effects of combining sulfonation with sub-millimeter laser machining.Materials today. Bio · 2023Article
- Removal Rate of the TomofixRevista brasileira de ortopedia · 2023Article
- Polyetheretherketone development in bone tissue engineering and orthopedic surgery.Frontiers in bioengineering and biotechnology · 2023Review
- Facile surface functional polyetheretherketone with antibacterial and immunoregulatory activities for enhanced regeneration toward bacterium-infected bone destruction.Drug delivery · 2021Article
- High Tibial Osteotomy for Varus Deformity of the Knee.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2021Review
- Day-Case Opening Wedge High Tibial Osteotomy With Intraosseous PEEK Implant.Arthroscopy, sports medicine, and rehabilitation · 2020Article
- Authors' response to critical comments: High tibial osteotomy with modern PEEK implants is safe and leads to lower hardware removal rates when compared to conventional metal fixation: a multi-center comparison study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020Article
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeVarious implant materials have been used in medial, opening-wedge high tibial osteotomy (HTO) including traditional metal and modern polyetheretherketone (PEEK) implants. The purpose of this study was to compare metal and PEEK implants and determine safety, varus deformity correction, as well as short- to mid-term hardware removal and arthroplasty rates.
methodsHTO performed with metal and PEEK implants were reviewed between 2000 and 2015 at two institutions with a minimum of 2 years follow-up. Postoperative complications, radiographic measures, and osteotomy union were compared between groups using Kruskal-Wallis and Fisher's exact testing. Survival free of hardware removal and arthroplasty was compared between groups using Kaplan-Meier testing. Risk factors for HTO conversion to arthroplasty were examined using Cox proportional hazards regression.
resultsNinety-five HTOs were performed in 90 patients (59 M, 31 F) using 50 metal and 45 PEEK implants. Mean follow-up was 4.2 years (range 2.0-16.5). Two metal and two PEEK HTO patients experienced nonunions, resulting in revision HTO at a mean of 1.0 years postoperatively (range 0.4-1.4 years). Both implant groups demonstrated similar, significant improvements in coronal deformity, with mean angulation improving from 6.0° and 5.4° varus preoperatively to 1.1° and 1.0° valgus postoperatively for the metal (p < 0.01) and PEEK groups (p < 0.01), respectively. 2- and 5-year hardware removal-free survival was 94% and 94% for PEEK, which was significantly superior to 80% and 73% observed for metal (p = 0.02). 2- and 5-year arthroplasty-free survival was similar for the metal (98% and 94%) and PEEK groups (100% and 78%) (n.s.). HTO performed for focal cartilage defects was observed to demonstrate decreased arthroplasty risk (HR 0.36, p = 0.03) when compared to HTO performed for osteoarthritis.
conclusionsBoth metal and PEEK implants were found to be effective in obtaining and maintaining coronal varus deformity correction, with 88% overall arthroplasty-free survival at 5 years. Metal fixation demonstrated a higher rate of hardware removal while HTO performed for medial compartment osteoarthritis predicted conversation to arthroplasty. LEVEL OF EVIDENCE: III.
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