ArticleJoint diseases and related surgery2024
Risk factors for delayed bone union in opening wedge high tibial osteotomy.
Article in Joint diseases and related surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Smoking and lateral hinge fracture are associated with delayed union at 6 months in open wedge distal tibial tuberosity osteotomy.Journal of experimental orthopaedics · 2026Article
- Auxiliary medial small locking plate fixation enhances bone healing and minimizes delayed union in inverted V-shaped high tibial osteotomy: A comparative study of 154 knees.Journal of experimental orthopaedics · 2026Article
- Article
- Evaluation of the effectiveness of Kirschner wires in preventing lateral hinge fractures in high tibial osteotomy: A finite element analysis.Joint diseases and related surgery · 2025Article
- Proximal partial fibular resection versus high tibial osteotomy: Comparative outcomes in early-stage knee osteoarthritis.Joint diseases and related surgery · 2025Article
- Is there a relationship between recurrence and obesity in the three-year mid-term follow-up of patients who underwent high tibial osteotomy due to medial gonarthrosis?Joint diseases and related surgery · 2025Article
- Novel anatomically contoured locking plate shows improved anatomic conformity vs. a conventional T-shaped plate in anterior popliteus transtibial-tuberosity high tibial osteotomy: a radiologic comparison.Frontiers in surgery · 2025Article
- Male Sex Is an Associated Factor for Delayed Bone Union Following Hybrid Closed-Wedge High Tibial Osteotomy.Medicina (Kaunas, Lithuania) · 2024Article
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Authors and funding
9 authors.
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Abstract
objectivesThe purpose of this study was to investigate the relationship between patient demographics and potential intraoperative factors and delayed bone union in opening wedge high tibial osteotomy (OWHTO). PATIENTS AND
methodsA retrospective review of 65 patients (37 females, 28 males; mean age: 60.1±10.1 years; range, 44 to 77 years) who underwent OWHTO using an angle-stable implant with beta-tricalcium phosphate gap filling between September 2016 and October 2019 was conducted. The osteotomy site was divided into five zones from the lateral hinge on anteroposterior radiographs, and we defined the zone in which bone healing was observed. The bone union area was assessed according to this definition at three, six, nine, and 12 months after surgery, and bone union was defined as union at the fourth zone or greater. A generalized estimating equations approach was employed to investigate longitudinal data pertaining to bone union area as a dependent variable. In addition, the association of bone union at six months postoperatively and predictors were evaluated using cross-sectional statistical methods. The categorical predictors included in the models were smoking, diabetes, hinge fracture, and autologous osteophyte grafting. The continuous variables included in the models were age, body mass index, opening gap width, and plate position.
resultsSmoking (odds ratio [OR]=0.478, p<0.01), large opening gap width (OR=0.941, p=0.014), and anterior plate placement (OR=0.971, p<0.01) were significantly associated with decreased bone union area. Union rate at six months in smokers was significantly lower compared to nonsmokers (16.6% and 67.8%, respectively; OR=0.10, p=0.023). Area under the curve in the receiver operating characteristic analysis for bone union at six months was 0.60 for gap width and 0.63 for plate placement.
conclusionSmoking, large opening gap width, and anterior plate placement are risk factors for delayed bone union after OWHTO. Surgeons should avoid anterior placement of the plate and carefully consider other options for smokers and those who require a large correction.
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