Evidence map›Paper›PMID 31385014›Full record

Observational studyInternational orthopaedics2020

Safety of simultaneous versus staged bilateral opening-wedge high tibial osteotomy with locked plate and immediate weight bearing.

Philippe Hernigou, David Giber, Arnaud Dubory, Jean Charles Auregan

Abstract readComparative StudyObservational Study
PubMed Publisher
In one paragraph

Observational study in International orthopaedics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
4.2field-weighted citation impact, top 6% 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

18 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.

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  16. Clinical course and outcomes of simultaneous-versus staged-bilateral medial opening wedge high tibial osteotomy.Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology · 2021
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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

4 authors at 2 institutions in 1 country.

Philippe HernigouHôpital Henri Mondor, 94010, Creteil, France. philippe.hernigou@wanadoo.fr.ORCID http://orcid.org/0000-0002-8475-279X
David GiberHôpital Henri Mondor, 94010, Creteil, France.
Arnaud DuboryHôpital Henri Mondor, 94010, Creteil, France.
Jean Charles AureganHôpital Antoine Béclère, 92140, Clamart, France.
Centre Hospitalier Universitaire Henri-Mondor · FRHôpital Antoine-Béclère · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWith advances in technology and particularly locked screws, patients with high tibial osteotomy (HTO) are frequently allowed full weight bearing for a  unilateral procedure. We are aware of no reports comparing the safety of a simultaneous bilateral HTO with staged bilateral HTO. The purpose of this study was to retrospectively compare these two strategies. MATERIAL AND

methodsNinety patients were treated with bilateral HTO surgery for osteoarthritis from 2009 to 2013; they had opening-wedge HTO and fixed with the same plate fixation and locked screws. A comparison of the outcomes after simultaneous bilateral HTO (35 patients) and after sequential staged bilateral HTO (55 patients) was performed. We considered four measures of medical safety: hypotension, serious intra-operative adverse event, heterologous blood transfusion, and thrombophlebitis. We considered also four measures of orthopaedic safety: infection, patient's inability to walk full weight bearing, changes in correction, and nonunion.

resultsFor the same duration of operation, the duration of anaesthesia and the time in the operating room were 35% longer for patients having a staged bilateral HTO. Blood loss was higher in patients undergoing simultaneous bilateral HTO compared with those who underwent a staged bilateral HTO. For patients undergoing simultaneous bilateral HTO, thrombophlebitis frequency and length of anticoagulation were lower than the sum of each event in the staged bilateral HTO. The patients with simultaneous bilateral HTO had a longer total period of time for crutches than patients with staged bilateral HTO. Patients in the simultaneous bilateral cohort did not develop an infection within one year as patients in the planned-stage cohort. The simultaneous bilateral cohort had a lower rate of delayed union than the planned-stage cohort did.

conclusionOn the basis of this analysis, simultaneous bilateral HTO is a reasonable treatment option. Individuals who undergo staged bilateral HTO face the risk of complications twice, in addition to two hospitalizations. Patients who undergo simultaneous bilateral HTO have a higher risk of blood transfusion.

Indexed as

AgedBone PlatesBone ScrewsFemaleHumansKnee JointMaleMiddle AgedOsteoarthritis, KneeOsteotomyRetrospective StudiesTibiaTreatment OutcomeWeight-BearingKnee osteoarthritisLocked screw for high tibial osteotomyOpening-wedge proximal tibia osteotomySimultaneous bilateral high tibial osteotomyStaged bilateral osteotomy

Identifiers

PMID31385014
OpenAlexW2965697132

What OpenQuestion holds

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Read underepoch 390

Registered trials

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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.