Purpose
The purpose of this study was to perform a retrospective clinical and radiographic
evaluation after opening-wedge high tibial osteotomy (HTO) using a short spacer plate
(Aescula; B. Braun Korea, Seoul, South Korea) and rigid long plate (TomoFix plate;
Mathys, Bettlach, Switzerland) at follow-up 2 years postoperatively.
Methods
We performed 94 opening-wedge HTOs with the Aescula plate (group I) and 92 HTOs with
the TomoFix plate (group II). Patients underwent clinical and radiographic evaluations
preoperatively and at 2 years postoperatively. Clinical evaluations were performed
with Knee Society scores. Radiographic analysis included the mechanical tibiofemoral
angle (mTFA) and the slope of the tibia angle with preoperative and postoperative
full weight–bearing anteroposterior whole-leg views, as well as anteroposterior, lateral,
and Merchant views of the knee. We measured the mTFA. In addition, we evaluated the
complications in each group. The follow-up period was 2 years.
Results
At follow-up 2 years postoperatively, we observed an overall complication rate of
38% in group I and 26% in group II (P = .083). We found plate-related complication rates of 20% in group I and 9% in group
II (P = .039). Plate-related complications included loss of correction, fracture of the
tibial plateau, screw failure, malunion, and fracture of the lateral cortical bone.
The mean mTFA was −6.0° ± 3.2° in group I and −4.6° ± 2.8° in group II preoperatively
(P = .262). The mean mTFA was 1.0° ± 3.1° in group I and 1.5° ± 2.3° in group II at
the latest follow-up (P = .034). In group I, the mean Knee Society knee score and function score were 60.0
± 12.9 and 57.9 ± 26.8, respectively, preoperatively. They improved to 92.1 ± 8.1
and 89.0 ± 15.1, respectively, at follow-up (P = .001 and P = .001, respectively). In group II, the mean Knee Society knee score and function
score were 57.5 ± 14.8 and 57.4 ± 22.1, respectively, preoperatively. They improved
to 95.5 ± 5.4 and 95.0 ± 7.6, respectively, at follow-up (P = .001 and P = .001, respectively). In addition, the mean postoperative knee score and function
score in group II were higher than those in group I (P = .001 and P = .001, respectively).
Conclusions
We have shown a high plate-related complication rate and a significant loss of correction
during a short-term follow-up period (2 years) after opening-wedge HTO using the new short
spacer HTO plate compared with the rigid long plate.
Level of Evidence
Level IV, therapeutic case series.
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Article info
Publication history
Published online: April 29, 2013
Accepted:
February 18,
2013
Received:
June 21,
2012
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
