Clinical and radiological outcomes of medial opening-wedge monoplanar and biplanar high tibial osteotomy using a triangular allograft impaction technique : A retrospective single centre study

Lauwers, Ruben; van Beek, Nathalie; Goossens, Daphne; Claes, Steven; Bartholomeeusen, Stijn; Claes, Toon

doi:10.1016/J.KNEE.2023.06.012

Title

Clinical and radiological outcomes of medial opening-wedge monoplanar and biplanar high tibial osteotomy using a triangular allograft impaction technique : A retrospective single centre study

Author

Lauwers, Ruben

van Beek, Nathalie

Goossens, Daphne

Claes, Steven

Bartholomeeusen, Stijn

Claes, Toon

Abstract

Purpose: The aim of the study was to research the clinical and radiological outcomes between monoplanar and biplanar medial opening-wedge high tibial osteotomy. We hypothesized that there would be no differences between both techniques when using a triangular allograft impaction technique. Methods: A single-centre, observational, retrospective study was conducted on 103 opening-wedge high tibial osteotomy patients from January 2017 to September 2019. Data collection, NRS and KOOS-PS, was performed preoperatively, 3 months and 12 months postoperatively. Radiological assessment (Kellgren-Lawrence, mechanical femoral-tibial angle, posterior tibial slope angle, lateral patellar tilt, patellar height) was performed on standing radiographs. Results: In total 32 patients were included in the biplanar group and 71 patients in the monoplanar group. NRS and KOOS-PS scores improved significantly (p < 0.001) in time for both groups from baseline to 3 m PO and further to 1 year postoperatively. Our results showed no differences in radiological outcomes such as patellar height, LPT and posterior tibial slope angle. The monoplanar group did have more Takeuchi I and III fractures and a higher mFTA angle without clinical repercussion. Conclusions: Using a triangular allograft impaction technique for monoplanar and biplanar medial opening-wedge high tibial osteotomy gives no differences in clinical (NRS and KOOS) and radiological outcomes. Although a difference in Takeuchi fractures was found for monoplanar patients, no additional fixation was necessary, nor did clinical complications occur. We can conclude that triangular allograft impaction technique creates a stable construct and standardizes the healing procedure postoperatively for both monoplanar and biplanar medial opening-wedge high tibial osteotomy. (c) 2023 Elsevier B.V. All rights reserved.

Language

English

Source (journal)

The knee. - Oxford

Publication

Oxford : 2023

ISSN

0968-0160

DOI

10.1016/J.KNEE.2023.06.012

Volume/pages

44 (2023) , p. 21-30