Skip to main content

Bone allograft provides bone healing in the medial opening high tibial osteotomy

Abstract

Various materials are used to fill osteotomy defects created in the medial opening wedge high tibial osteotomy (MOWHTO). Our hypothesis was that a bone allograft would provide the osteotomy site bone healing within the expected time. We performed the MOWHTO using a cancellous bone allograft in 310 knees in 284 patients between 2000 and 2005. Internal fixation was achieved with a T-profile AO plate. Preoperative and postoperative radiographic measurements were taken and statistically processed. All patients were followed up for a period ranging from three to eight years, or 5.9 years on average. Implanted cancellous bone allografts ≤9 mm healed within 12 weeks in 90% of cases. With the properly selected patient and surgical technique, use of a cancellous bone allograft in MOWHTO represents a satisfactory choice in providing bone healing.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3

References

  1. Amendola A, Fowler PJ, Litchfield R, Kirkley S, Clatworthy M (2004) Opening wedge high tibial osteotomy using a novel technique: early results and complications. J Knee Surg 17:164–169

    CAS  PubMed  Google Scholar 

  2. Aryee S, Imhoff AB, Rose T, Tischer T (2008) Do we need synthetic osteotomy augmentation materials for opening-wedge high tibial osteotomy? Biomaterials 29:3497–3502

    Article  CAS  PubMed  Google Scholar 

  3. Brouwer RW, Bierma-Zeinstra SMA, van Raaij TM, Verhaar JAN (2006) Osteotomy for medial compartment arthritis of the knee using a closing wedge or an opening wedge controlled by a Puddu plate. J Bone Joint Surg Br 88:1454–1459

    Article  CAS  PubMed  Google Scholar 

  4. Coventry MB, Ilstrup DM, Wallrichs SL (1993) Proximal tibial osteotomy: a critical long-term study of eighty-seven cases. J Bone Joint Surg Am 75:196–201

    CAS  PubMed  Google Scholar 

  5. Dugdale TW, Noyes FR, Styer D (1992) Preoperative planning for high tibial osteotomy: the effect of lateral tibiofemoral separation and tibiofemoral length. Clin Orthop Relat Res 274:248–264

    PubMed  Google Scholar 

  6. Gaasbeek RDA, Nicolaas L, Rijnberg WJ, Van Loon CJM, Van Kampen A (2009) Correction accuracy and collateral laxity in open versus closed wedge high tibial osteotomy. A one year randomized controlled study. Int Orthop. doi:10.1007/s00264-009-0861-7

    PubMed  Google Scholar 

  7. Heary RF, Schlenk RP, Sacchieri TA, Barone D, Brotea C (2002) Persistent iliac crest donor site pain: independent outcome assessment. Neurosurgery 50:510–516

    Article  PubMed  Google Scholar 

  8. Hernigou P, Ovadia H, Goutallier D (1992) Mathematical modelling of open wedge tibial osteotomy and correction tables. Rev Chir Orthop Reparatrice Appar Mot 78:258–263

    CAS  PubMed  Google Scholar 

  9. Hernigou P, Ma W (2001) Open wedge tibial osteotomy with acrylic bone cement as bone substitute. Knee 8:103–110

    Article  CAS  PubMed  Google Scholar 

  10. Hernigou P, Medevielle D, Debeyre J, Goutallier D (1987) Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study. J Bone Joint Surg Am 69:332–354

    CAS  PubMed  Google Scholar 

  11. Koshino T, Murase T, Saito T (2003) Medial opening-wedge high tibial osteotomy with use of porous hydroxyapatite to treat medial compartment osteoarthritis of the knee. J Bone Joint Surg Am 85:78–85

    Article  PubMed  Google Scholar 

  12. Marti RK, Verhagen RA, Kerkhoffs GM, Moojen TM (2001) Proximal tibial varus osteotomy: indications, technique, and five to twenty-one-year results. J Bone Joint Surg Am 83:164–170

    PubMed  Google Scholar 

  13. Naudie D, Bourne RB, Rorabeck CH, Bourne TJ (1999) Survivorship of the high tibial valgus osteotomy: a 10 to 22 year follow-up study. Clin Orthop Relat Res 367:18–27

    Article  PubMed  Google Scholar 

  14. Nelissen EM, Van Langelaan EJ, Nelissen RGHH (2009) Stability of medial opening wedge high tibial osteotomy: a failure analysis. Int Orthop. doi:10.1007/s00264-009-0723-3

    Google Scholar 

  15. Noyes FR, Mayfield W, Barber-Westin SD, Albright JC, Heckeman TP (2006) Opening wedge high tibial osteotomy. An operative technique and rehabilitation program to decrease complications and promote early union and function. Am J Sports Med 34:1262–1273

    Article  PubMed  Google Scholar 

  16. Rodner CM, Adams DJ, Diaz-Doran V, Tate JP, Santangelo SA, Mazzocca AD, Arciero RA (2006) Medial opening wedge tibial osteotomy and the sagittal plane. Am J Sports Med 34:1431–1441

    Article  PubMed  Google Scholar 

  17. Santic V, Legovic D (2007) The clinic for orthopaedic surgery Lovran bone bank. Acta Med Croatica 61:487–489

    PubMed  Google Scholar 

  18. Spahn G, Wittig R (2002) Primary stability of various implants in tibial opening wedge osteotomy: a biomechanical study. J Orthop Sci 7:683–687

    Article  PubMed  Google Scholar 

  19. Tunggal JAW, Higgins GA, Waddell JP (2009) Complications of closing wedge high tibial osteotomy. Int Orthop. doi:10.1007/s00264-009-0819-9

    PubMed  Google Scholar 

  20. Warden SJ, Morris HG, Crossley KM, Brukner PD, Bennell KL (2005) Delayed and non-union following opening wedge high tibial osteotomy: surgeons’ results from 182 completed cases. Knee Surg Sports Traumatol Arthrosc 13:34–37

    Article  PubMed  Google Scholar 

  21. Westrich GH, Peters LE, Haas SB, Buly RL, Windsor RE (1998) Patella height after high tibial osteotomy with internal fixation and early motion. Clin Orthop Relat Res 354:169–174

    Article  PubMed  Google Scholar 

  22. Wright JM, Crockett HC, Slawski DP, Madsen MW, Winsdor RE (2005) High tibial osteotomy. J Am Acad Orthop Surg 13:279–289

    PubMed  Google Scholar 

  23. Yacobucci GN, Cocking MR (2008) Union of medial opening wedge high tibial osteotomy using a corticocancellous proximal tibial wedge allograft. Am J Sports Med 36:713–719

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Veljko Santic.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Santic, V., Tudor, A., Sestan, B. et al. Bone allograft provides bone healing in the medial opening high tibial osteotomy. International Orthopaedics (SICOT) 34, 225–229 (2010). https://doi.org/10.1007/s00264-009-0916-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-009-0916-9

Keywords

  • High Tibial Osteotomy
  • Bone Allograft
  • Correction Angle
  • Autologous Bone Graft
  • Varus Malalignment