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Introducing prospective national registration of knee osteotomies. A report from the first year in Sweden

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Abstract

Purpose

Knee osteotomy is a joint preserving surgery with new techniques and implants introduced during recent years. However the information of its use and outcome is scarce. A national knee osteotomy register was started in Sweden in 2013 from which we report here the information gathered during the first year of registration.

Methods

All patients having knee osteotomy (distal femur and proximal tibia), primaries and re-operations are intended to be included in the prospective registration. Reporting to the register is based on a paper form including information on the patient (ID, sex, age, American Society of Anesthesiologists classification [ASA], weight and height) surgical date, hospital, diagnosis, pre-operative alignment and grade of osteoarthritis (OA), part and LOT numbers of implants, surgical technique, prophylaxis (antithrombotic and antibiotic) and operating time.

Results

During the first year (April 2013 to March 2014), 34 clinics reported 220 primary knee osteotomies (209 proximal tibia and 11 distal femur). We estimate that this represents almost 80 % of those performed on the adult population during the period. The majority of the patients were classified as healthy (60 % ASA grade 1), were men (66 %) and the median age was 51 years (range 19–67). Proximal tibia osteotomy for OA performed with open wedge osteotomy using internal fixation without bone transplantation was most commonly reported.

Conclusions

As relatively few patients are being treated with different types of fixation and bone substitution in Sweden as well as the rapid development of techniques and new implants, a nationwide registration of knee osteotomies is relevant.

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References

  1. Tjörnstrand B, Egund N, Hagstedt BV (1981) Tibial osteotomy in medial gonarthrosis. The importance of over-correction of varus deformity. Arch Orthop Trauma Surg 99(2):83–89

    Article  PubMed  Google Scholar 

  2. Knutson K, Lewold S, Robertsson O, Lidgren L (1994) The Swedish knee arthroplasty register. A nation-wide study of 30,003 knees 1976–1992. Acta Orthop Scand 65(4):375–386

    Article  CAS  PubMed  Google Scholar 

  3. W-Dahl A, Robertsson O, Lohmander LS (2012) High tibial osteotomy in Sweden, 1998–2007: a population-based study of the use and rate of revision to knee arthroplasty. Acta Orthop 83(3):244–248

    Article  PubMed Central  PubMed  Google Scholar 

  4. Ahlback S (1968) Osteoarthrosis of the knee. A radiographic investigation. Acta Radiol Diagn 277:7–72

    Google Scholar 

  5. Pongsoipetch B, Tantikul C (2009) Open-wedge high tibial osteotomy in varus knee osteoarthritis: a 5-year prospective cohort study. J Med Assoc Thai 92(Suppl 6):109–114

    Google Scholar 

  6. Zaki SH, Rae PJ (2009) High tibial valgus osteotomy using the Tomofix plate–medium-term results in young patients. Acta Orthop Belg 75(3):360–367

    PubMed  Google Scholar 

  7. Bode G, von Heyden J, Pestka J, Schmal H, Salzmann G, Südkamp N, Niemeyer P (2013) Prospective 5-year survival rate data following open-wedge valgus high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc. Nov 19 [Epub ahead of print]

  8. Osti M, Gohm A, Schlick B, Benedetto KP (2013) Complication rate following high tibial open-wedge osteotomy with spacer plates for incipient osteoarthritis of the knee with varus malalignment. Knee Surg Sports Traumatol Arthrosc. Nov 6 [Epub ahead of print]

  9. van Egmond N, van Grinsven S, van Loon CJ, Gaasbeek RD, van Kampen A (2014) Better clinical results after closed- compared to open-wedge high tibial osteotomy in patients with medial knee osteoarthritis and varus leg alignment. Knee Surg Sports Traumatol Arthrosc. Sep 13 [Epub ahead of print]

  10. El-Assal MA, Khalifa YE, Abdel-Hamid MM, Said HG, Bakr HM (2010) Opening-wedge high tibial osteotomy without bone graft. Knee Surg Sports Traumatol Arthrosc 18(7):961–966

    Article  PubMed  Google Scholar 

  11. Staubli AE, Jacob HA (2010) Evolution of open-wedge high-tibial osteotomy: experience with a special angular stable device for internal fixation without interposition material. Int Orthop 34(2):167–172

    Article  PubMed Central  PubMed  Google Scholar 

  12. Brosset T, Pasquier G, Migaud H, Gougeon F (2011) Opening wedge high tibial osteotomy performed without filling the defect but with locking plate fixation (TomoFix™) and early weight-bearing: prospective evaluation of bone union, precision and maintenance of correction in 51 cases. Orthop Traumatol Surg Res 97(7):705–711

    Article  CAS  PubMed  Google Scholar 

  13. Takeuchi R, Bito H, Akamatsu Y, Shiraishi T, Morishita S, Koshino T, Saito T (2010) In vitro stability of open wedge high tibial osteotomy with synthetic bone graft. Knee 17(3):217–220

    Article  PubMed  Google Scholar 

  14. Schwartz CE, Martha JF, Kowalski P, Wang DA, Bode R, Li L, Kim DH (2010) Prospective evaluation of chronic pain associated with posterior autologous iliac crest bone graft harvest and its effect on postoperative outcome. Health Qual Life Outcomes 29(7):49

  15. Martin R, Birmingham TB, Willits K, Litchfield R, Lebel ME, Giffin JR (2014) Adverse event rates and classifications in medial opening wedge high tibial osteotomy. Am J Sports Med 42(5):1118–1126

    Article  PubMed  Google Scholar 

  16. The Swedish Knee Arthroplasty Register (2014) Annual report 2014. http://www.knee.se. Accessed 05 December 2014

  17. Stefánsdóttir A, Robertsson O, W-Dahl A, Kiernan S, Gustafson P, Lidgren L (2009) Inadequate timing of prophylactic antibiotics in orthopedic surgery. We can do better. Acta Orthop 80(6):633–638

    Article  PubMed Central  PubMed  Google Scholar 

  18. W-Dahl A, Robertsson O, Stefánsdóttir A, Gustafson P, Lidgren L (2011) Timing of preoperative antibiotics for knee arthroplasties: improving the routines in Sweden. Patient Saf Surg 5:22

    Article  PubMed Central  PubMed  Google Scholar 

  19. Cotic M, Vogt S, Feucht MJ, Saier T, Minzlaff P, Hinterwimmer S, Imhoff AB (2014) Prospective evaluation of a new plate fixator for valgus-producing medial open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc. Sep 11 [Epub ahead of print]

  20. Han SB, Bae JH, Lee SJ, Jung TG, Kim KH, Kwon JH, Nha KW (2014) Biomechanical properties of a new anatomical locking metal block plate for opening wedge high tibial osteotomy: uniplane osteotomy. Knee Surg Relat Res 26(3):155–161

    Article  PubMed Central  PubMed  Google Scholar 

  21. Petersen W, Wall A, Paulin T, Park HU, Heymann L (2014) Stability of two angular stable locking plates for open wedge high tibial osteotomy (HTO): TomoFix™ versus LOQTEQ® HTO plate. Arch Orthop Trauma Surg. Jul 12 [Epub ahead of print]

  22. Uemura K, Kanamori A, Aoto K, Yamazaki M, Sakane M (2014) Novel unidirectional porous hydroxyapatite used as a bone substitute for open wedge high tibial osteotomy. J Mater Sci Mater Med Jul 5

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W-Dahl, A., Lidgren, L., Sundberg, M. et al. Introducing prospective national registration of knee osteotomies. A report from the first year in Sweden. International Orthopaedics (SICOT) 39, 1283–1288 (2015). https://doi.org/10.1007/s00264-014-2621-6

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  • DOI: https://doi.org/10.1007/s00264-014-2621-6

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