ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2023
Closed-wedge high tibial osteotomy is more advantageous to maintain the correction than open-wedge high tibial osteotomy in osteopenic patients.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Comparison of Patellofemoral Degeneration After Three Types of High Tibial Osteotomy: Retrotuberosity Biplane Open-Wedge, Supratuberosity Biplane Open-Wedge, and Closed-Wedge Techniques.Orthopaedic journal of sports medicine · 2026Article
- Influences of Tibial Plateau Morphology on JLCA Change, Clinical Outcomes and Cartilage Regeneration After Medial Opening Wedge High Tibial Osteotomy.Orthopaedic journal of sports medicine · 2026Article
- Impact of a Unilateral High Tibial Osteotomy With a Large Correction on Functional Lateral Acetabular Coverage of the Hip Joint.Orthopaedic journal of sports medicine · 2024Article
- Difference in Correction Power between Hybrid Lateral Closed-Wedge High Tibial Osteotomy and Medial Open-Wedge High Tibial Osteotomy was Associated with Severity of Varus Deformity and Different Hinge Distance from Center of Deformity.Diagnostics (Basel, Switzerland) · 2024Article
- Surgical accuracy of coronal and sagittal alignment in conventional closed-wedge high tibial osteotomy after computer-assisted surgery experience.Knee surgery & related research · 2023Article
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4 authors.
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Abstract
purposeTo compare the incidence of correction loss and survival rate between closed-wedge and open-wedge high tibial osteotomies (CWHTO and OWHTO, respectively) in patients with osteopenic and normal bone.
methodsRetrospective review was conducted for 115 CWHTOs and 119 OWHTOs performed in osteopenic patients [- 2.5 < Bone mineral density (BMD) T scores ≤ - 1] and 136 CWHTOs and 138 OWHTOs performed in normal patients (BMD T score > - 1) from 2012 to 2019. Demographics were not different between CW- and OWHTOs in osteopenic and normal patients (n.s., respectively). Radiographically, the mechanical axis (MA), medial proximal tibial angle (MPTA), and posterior tibial slope (PTS) were evaluated pre- and postoperatively (2 weeks after HTO). The occurrence of hinge fractures was investigated using radiographs taken on the operation day. The correction change was calculated as the last follow-up value minus postoperative MPTA. Correction loss was defined when the correction change was ≥ 3°. The survival rate (failure: correction loss) was investigated.
resultsThere were no significant differences in the pre and postoperative MA, MPTA, PTS, and value changes between CW- and OWHTOs in osteopenic and normal patients (n.s., respectively); the incidence of unstable hinge fractures also did not differ significantly (CWHTO vs. OWHTO = 7 vs. 7.6% in osteopenic patients; 2.9 vs. 3.6% in normal patients; n.s., respectively). The average correction change (CWHTO = - 0.6°, OWHTO = - 1.3°, p = 0.007), incidence of correction loss (CWHTO = 1.7%, OWHTO = 9.2%, p = 0.019), and 5-year survival rates (CWHTO = 98.3%, OWHTO = 90.8%, p = 0.013) differed significantly in osteopenic patients; there were no significant differences in these results in normal patients (n.s., respectively).
conclusionCWHTO was more advantageous than OWHTO regarding the correction loss in osteopenic patients. Intra- and postoperative care that consider poor bone quality will be required when performing OWHTOs in osteopenic patients. LEVEL OF EVIDENCE: III.
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